An attempt to improve pure neural leprosy diagnosis using immunohistochemistry tests in peripheral nerve biopsy specimens.

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TitleAn attempt to improve pure neural leprosy diagnosis using immunohistochemistry tests in peripheral nerve biopsy specimens.
Publication TypeJournal Article
AuthorsFerreira Medeiros M, Jardim MR, Vital RT, da Nery JAC, Sales AM, de Moraes MO, Chimelli LM, Vidal Pessolani MC, Ferreira H, Sarno EN, Antunes SLG
Abbrev. JournalAppl. Immunohistochem. Mol. Morphol.
JournalApplied immunohistochemistry & molecular morphology : AIMM
Year of Publication2014
Volume22
Issue3
Pagination222-30
Publication Languageeng
KeywordsAdolescent, Adult, Aged, Antigens, Bacterial, Biopsy, DNA, Bacterial, Female, Glycolipids, Humans, Immunohistochemistry, Leprosy, Tuberculoid, Lipopolysaccharides, Male, Middle Aged, Mycobacterium leprae, Peripheral nerves, Quality improvement, Young Adult
Abstract

The diagnosis of pure neural leprosy (PNL) is based on clinical and laboratory data, including the histopathology of nerve biopsy specimens and detection of Mycobacterium leprae DNA by polymerase chain reaction (PCR). Given that histopathologic examination and PCR methods may not be sufficient to confirm the diagnosis, immunolabeling of lipoarabinomanan (LAM) and/or phenolic glycolipid 1 (PGL-1) M. leprae wall components was utilized in the present investigation in an attempt to detect any vestigial presence of M. leprae in acid-fast bacilli (AFB) nerve samples. Twenty-three PNL nerve samples (6 AFB and 17 AFBPCR) were cryosectioned and subjected to LAM and PGL-1 immunohistochemical staining by immunoperoxidase. Five nonleprosy nerve samples were used as controls. The 6 AFB samples showed LAM/PGL-1 immunoreactivity. Among the 17 AFB samples, 8 revealed LAM and/or PGL-1 immunoreactivity. In 17 AFBPCR patients, just 7 yielded LAM and/or PGL-1 nerve results. In the PNL cases, the detection of immunolabeled LAM and PGL-1 in the nerve samples would have contributed to an enhanced diagnostic efficiency in the absence of molecular diagnostic facilities.

PubMed URL

http://www.ncbi.nlm.nih.gov/pubmed/23702646?dopt=Abstract

DOI10.1097/PAI.0b013e31828dc70c

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