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

2016; Elsevier BV; Volume: 86; Issue: 2 Linguagem: Inglês

10.1016/j.diagmicrobio.2016.07.024

1879-0070

Aline Araújo Freitas, Emerith Mayra Hungria, Maurício Barcelos Costa, Ana Lúcia Osório Maroccolo de Sousa, Mirian Lane Oliveira Rodrigues Castilho, Heitor S. Gonçalves, Maria Araci de Andrade Pontes, Malcolm S. Duthie, Mariane M. A. Stefani,

Infectious Diseases and Tuberculosis

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