Application of Mycobacterium Leprae-specific cellular and serological tests for the differential diagnosis of leprosy from confounding dermatoses

作者：Freitas Aline Araujo; Hungria Emerith Mayra; Costa Mauricio Barcelos; Osorio Maroccolo Sousa Ana Lucia; Oliveira Castilho Mirian Lane; Goncalves Heitor Sa; Andrade Pontes Maria Araci; Duthie Malcolm S; Araujo Stefani Mariane Martins

来源：Diagnostic Microbiology and Infectious Disease, 2016, 86(2): 163-168.

DOI：10.1016/j.diagmicrobio.2016.07.024

• Leprosy
• Differential diagnosis of leprosy
• Other dermatoses
• Serology
• Cellular immunity

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/IFN gamma stimulated with LID-1 antigen and ELISA tests for IgG to LID-1 and IgM to PGL-I were performed. WBA/LID-1/IFN gamma 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.

• 出版日期2016-10