Article
An Attempt to Improve Pure Neural Leprosy Diagnosis Using Immunohistochemistry Tests in Peripheral Nerve Biopsy Specimens
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MEDEIROS, Mildred Ferreira et al. An Attempt to Improve Pure Neural Leprosy Diagnosis Using Immunohistochemistry Tests in Peripheral Nerve Biopsy Specimens. Appl Immunohistochem Mol Morphol, v.22,n.3, March 2014.
1532-4058
10.1097/PAI.0b013e31828dc70c.
Autor
Medeiros, Mildred Ferreira
Jardim, Márcia Rodrigues
Vital, Robson Teixeira
Nery, José Augusto da Costa
Sales, Anna Maria
Moraes, Milton Ozorio de
Chimelli, Leila Maria
Pessolani, Maria Cristina Vidal
Ferreira, Helen
Sarno, Euzenir Nunes
Antunes, Sérgio Luiz Gomes
Resumen
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 AFB PCR+) 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 AFB PCR+ 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.