02057nas a2200325   4500000000100000008004100001260001300042653002600055653002400081653001100105653003800116653001600154653001100170653002100181653001200202653002500214653002200239653003000261653003100291653000900322100001600331700001500347700001200362245007000374856004100444300001100485490000700496520121400503022001401717       1991                            d  c1991 Sep10aAntibodies, Bacterial10aAntigens, Bacterial10aBiopsy10aEnzyme-Linked Immunosorbent Assay10aGlycolipids10aHumans10aImmunoglobulin M10aleprosy10aMycobacterium leprae10aPeripheral nerves10aPredictive Value of Tests10aReproducibility of Results10aSkin1 aLefford M J1 aHunegnaw M1 aSiwik E00aThe value of IgM antibodies to PGL-I in the diagnosis of leprosy.  uhttp://ila.ilsl.br/pdfs/v59n3a07.pdf  a432-400 v593 a<p>An ELISA has been used to measure IgM antibodies to phenolic glycolipid-I (PGL-I) in previously undiagnosed patients who were suspected of leprosy on purely clinical grounds. The certainty of clinical diagnosis was classified as either "firm" or "indefinite." Leprosy was confirmed in 133 of 161 patients on the basis of positive slit-skin smears and/or skin and/or nerve histopathology. All 58 patients with multibacillary leprosy (BB, BL, or LL) were correctly diagnosed clinically, as were 50 of 54 patients (93%) with a firm diagnosis of BT or TT leprosy. The firm clinical diagnoses were more accurate than either the slit-skin smear or ELISA data. However, there were 44 patients (27% of total), designated "rule out leprosy" (RO), for whom the clinical diagnosis was indefinite. The clinical suspicion of leprosy (RO) was correct in only 24 (55%) of these patients who had BT leprosy. The slit-skin smears were positive in only 20% of these patients compared to 50% for the ELISA. It was concluded that the PGL-I IgM ELISA may have its greatest diagnostic confirmatory value in paucibacillary disease because paucibacillary leprosy comprises the major source of clinical diagnostic difficulty.</p>
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