Deteccion de amastigotas en Leishmaniasis cutanea y mucocutanea por el metodo de inmunoperoxidasa, usando anticuerpo policlonal: sensibilidad y especificidad comparadas con metodos convencionales de diagnostico

Abstract

The indirect immunoperoxidase method was evaluated in 265 biopsies with the purpose of increasing the sensitivity of the diagnostic histopathology of tegumentary lesions caused by subspecies of the Leishmania braziliensis complex. A diagnosis of leishmaniasis was established by parasitological methods (181) or clinical criteria (12) in 193 patients (72.8%). In the latter group of confirmed cases standard histochemistry and immunoperoxidase were compared with direct examination of tissue scraping and culture of lesion aspirates. The detection and localization of amastigotes was more efficient using the immunoperoxidase method (61.3%) than conventional histopathology with hematoxilin and eosin (34.6%) or direct examination of tissue scraping (43.9%). However, culture of lesion aspirates was the most sensitive procedure (89.8%). The efficiency of the immunoperoxidase method was greater in recent lesions, being positive in 75% of cases with less than 3 months evolution, while 55.6%, 37.5%, and 21.1% of cases with lesion evolution of 3-5.9, 6-11, and 12 months or greater, respectively, were positive. The combined use of the direct examination of lesion scraping and immunoperoxidase applied to histological sections of the biopsy from the lesion border allowed an etiologic diagnosis of 72% of confirmed cases. Cross-reactivity was observed with Paracoccidioides braziliensis but not with Mycobacterium leprae, Sporothrix schenckii, or Histoplasma capsulatum.

Leishmanial antigens in the diagnosis of active lesions and ancient scars of American tegumentary leishmaniasis patients

“…In Groups II and III, cellular and vascular patterns persisted in scars, albeit there was a striking drop in positivity throughout time (χ 2 for Linear Trends, p<0.000001) (Weigle et al 1987, Brujin et al 1993. In this study the immunoperoxidade technique was the most sensitive method for detection of amastigotes in active lesions and association of different methods resulted in increased sensitivity (Table III), as also demonstrated by others (Livni et al 1983, Salinas et al 1989. Even though, in 7 out of 47 patients of Group I, demonstration of parasites could not be done.…”

“…Although vascular and cellular pattern positivity have been previously described (Sells & Burton 1981, Ridley & Ridley 1986, Salinas et al 1989, Sotto et al 1989) their possible value in the diagnosis of the disease was not stressed. In our work the cellular, vascular and neural patterns permitted that immunoperoxidade technique positive results reached from 58.5% (amastigote) to 92.5% in Group I.…”

“…However only fungal structures were positive in their biopsies and none of the other immunostaining patterns were detected. Others (Salinas et al 1989) described cross reactivity with P. brasiliensis.…”

Immunoperoxidase technique using an anti-Leishmania (L.) chagasi hyperimmune serum in the diagnosis of culture-confirmed American tegumentary leishmaniasis

“…More recent methods for detection of the parasite such as immunohistochemistry (IHC) [7][8][9]13,[15][16][17] and polymerase chain reaction (PCR) 6,11,12,18 have been shown to be more sensitive and are beginning to be established in the laboratory routine as auxiliary or alternative methods. Considering this detection and regarding diagnostic performance parameters (sensitivity, e.g.…”

Leishmaniasis mucosa y otras lesiones destructivas centrofaciales

“…La búsqueda del parásito no se dió por terminada sin estudiar antes las láminas, por lo menos, durante 10 minutos. En aquéllas en las que el patrón histológico sugirió que se trataba de leishmaniasis, sin demostración del parásito a la HE, se realizó la inmunohistoquímica con anticuerpo policlonal antileishmaniagentilmentecedido por el ClDElM de Cali (3). Como controles positivos se utilizaron casos de leishmaniasis cutá-nea ricos en amastigotes y 20 casos de leishmaniasis mucocutánea en los cuales se visualizaron los oarásitos con la HE.…”