|
|||||
|
|
Immunohistochemistry and polymerase chain reaction on paraffin-embedded material improve the diagnosis of cutaneous leishmaniasis in the Amazon region |
|
| Authors: | Valdir Sabbaga Amato Felipe Francisco Tuon Heitor Franco de Andrade Jr Helio Bacha Carla Pagliari Elaine Raniero Fernandes Maria Irma Seixas Duarte Vicente Amato Neto Ricardo Andrade Zampieri Lucile Maria Floeter-Winter Beatriz J. Celeste Juliane Oliveira Mariana Martinez Quiroga Melissa Mascheretti Marcos Boulos |
| Affiliation: | From the Infectious and Parasitic Diseases Clinic and Laboratory of Medical Investigation, Parasitology (LIM 46), Hospital das Clínicas, Department of Infectious Diseases, Laboratory of Protozoology, Institute of Tropical Medicine of Sao Paulo, Laboratory of the Discipline of Pathology of Transmissible Diseases, and NUMETROP, Núcleo de Extensão em Medicina Tropical, Department of Infectious Diseases, University of São Paulo Medical School, and Laboratory of Trypanosomatids, Physiology Department, Biosciences Institute and Seroepidemiology Laboratory, Instituto de Medicina Tropical de São Paulo, University of São Paulo, São Paulo, Brazil |
| Abstract: | Background Recently, there has been an increase in the incidence of cutaneous leishmaniasis (CL), which represents an important health problem. This increase may be related to the epidemiologic expansion of the infective agent and the increase in tourism in tropical areas. The difficulty in clinical diagnosis, mainly in areas in which CL is not the first consideration of local physicians, has intensified efforts to describe diagnostic tests, which should be specific, sensitive, and practical. Amongst the new tests described are those including nucleic acid amplification (polymerase chain reaction, PCR) and immunohistochemistry (IHC). Methods In this study, we evaluated the sensitivity of a PCR based on small subunit (SSU) ribosomal DNA, in comparison with IHC using Leishmania spp. antibodies, in biopsies embedded in paraffin. Result The results indicated a total sensitivity of 96% (90.9% with PCR and 68.8% with IHC), showing the possibility of using paraffin-embedded biopsies to diagnose CL. Conclusion We propose the use of the two tests together as a routine protocol for diagnosis. This would require the provision of local medical services to perform molecular biology techniques and adequate Leishmania antibodies. |
| Keywords: | |