학술논문
Application of Mycobacterium Leprae-specific cellular and serological tests for the differential diagnosis of leprosy from confounding dermatoses.
Document Type
Academic Journal
Author
Freitas AA; Tropical Pathology and Public Health Institute, Federal University of Goiás, Goiânia, Brazil.; Hungria EM; Tropical Pathology and Public Health Institute, Federal University of Goiás, Goiânia, Brazil.; Costa MB; Tropical Pathology and Public Health Institute, Federal University of Goiás, Goiânia, Brazil.; Sousa AL; Tropical Pathology and Public Health Institute, Federal University of Goiás, Goiânia, Brazil.; Castilho ML; Hospital of Tropical Diseases (Hospital de Doenças Tropicais Dr Anuar Auad HDT/HAA), Goiânia, Goiás, Brazil.; Gonçalves HS; Centro de Dermatologia Dona Libânia (CDERM), Fortaleza, Ceará, Brazil.; Pontes MA; Centro de Dermatologia Dona Libânia (CDERM), Fortaleza, Ceará, Brazil.; Duthie MS; Infectious Disease Research Institute (IDRI), Seattle, WA, USA.; Stefani MM; Tropical Pathology and Public Health Institute, Federal University of Goiás, Goiânia, Brazil. Electronic address: mmastefani@gmail.com.
Source
Publisher: Elsevier Biomedical Country of Publication: United States NLM ID: 8305899 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-0070 (Electronic) Linking ISSN: 07328893 NLM ISO Abbreviation: Diagn Microbiol Infect Dis Subsets: MEDLINE
Subject
Language
English
Abstract
Mycobacterium leprae-specific serological and cell-mediated-immunity/CMI test were evaluated for the differential diagnosis of multibacillary/MB, and paucibacillary/PB leprosy from other dermatoses. Whole-blood assay/WBA/IFNγ stimulated with LID-1 antigen and ELISA tests for IgG to LID-1 and IgM to PGL-I were performed. WBA/LID-1/IFNγ production was observed in 72% PB, 11% MB leprosy, 38% dermatoses, 40% healthy endemic controls/EC. The receiver operating curve/ROC for WBA/LID-1 in PB versus other dermatoses showed 72.5% sensitivity, 61.5% specificity and an area-under-the-curve/AUC=0.75; 74% positive predictive value/PPV, 59% negative predictive value/NPV. Anti PGL-I serology was positive in 67% MB, 8% PB leprosy, 6% of other dermatoses; its sensitivity for MB=66%, specificity=93%, AUC=0.89; PPV=91%, NPV=72%. Anti-LID-1 serology was positive in 87% MB, 7% PB leprosy, all other participants were seronegative; 87.5% sensitivity for MB, 100% specificity, AUC=0.97; PPV=100%, NPV=88%. In highly endemic areas anti-LID-1/PGL-I serology and WBA/LID-1-represent useful tools for the differential diagnosis of leprosy from other confounding dermatoses.
(Copyright © 2016 Elsevier Inc. All rights reserved.)
(Copyright © 2016 Elsevier Inc. All rights reserved.)