title: Immunoblotting as a valuable tool to differentiate human visceral leishmaniasis from lymphoproliferative disorders and other clinically similar diseases.
abstract: Diseases presenting with splenomegaly, fever and pancytopenia require intensive differential diagnostic considerations. These diseases include lymphoproliferative and autoimmune diseases, but also chronic infections like mansonian schistosomiasis or visceral leishmaniasis (kala-azar). Diagnosis for the latter is usually performed by testing for the presence of antileishmanial antibodies using the immunofluorescence test (IFT) or the enzyme-linked immunosorbent assay (ELISA) technique. Here, we report on patients who displayed positive antileishmanial antibody titres in the IFT and/or ELISA, but did not develop kala-azar and were eventually diagnosed as having one of the non-kala-azar diseases listed above. These false-positive sera proved to be seronegative when tested on a Leishmania immunoblot. Our studies lead us to recommend the immunoblot technique as a confirmatory test in cases with doubtful IFT or ELISA antibody titres.
authors.affiliation: Institute of Clinical Microbiology, University of Erlangen-Nürnberg, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Hoerauf
authors.forename: P P
authors.initials: PP
authors.lastname: Andrade
authors.forename: C R
authors.initials: CR
authors.lastname: Andrade
authors.forename: W
authors.initials: W
authors.lastname: Solbach
authors.forename: M
authors.initials: M
authors.lastname: Röllinghoff
mesh_terms: D000818:Animals; D000913:Antibodies, Protozoan / Q000097:blood; D001327:Autoimmune Diseases / Q000175:diagnosis; D003937:Diagnosis, Differential; D004797:Enzyme-Linked Immunosorbent Assay; D005069:Evaluation Studies as Topic; D005189:False Positive Reactions; D005455:Fluorescent Antibody Technique; D006801:Humans; D015151:Immunoblotting / Q000379:methods*; D007893:Leishmania donovani / Q000276:immunology; D007898:Leishmaniasis, Visceral / Q000175:diagnosis* / Q000276:immunology; D008232:Lymphoproliferative Disorders / Q000175:diagnosis*; D012555:Schistosomiasis mansoni / Q000175:diagnosis
chemical_list: D000913:Antibodies, Protozoan