title: Immuno-histopathology in the diagnosis of early leprosy.
abstract: The present study of 45 early leprosy cases in an endemic area in China indicates: a) Sensitivity of acid-fast bacilli (AFB) detection can be significantly improved by examining approximately 30 serial sections. AFB and/or phenolic glycolipid-I (PGL-I) were mostly detected in the infiltrates in the subepidermal zone, intraneurium, perineurium and around blood vessels. b) PGL-I antigen was positive in 10 clinically suspected, single lesion leprosy cases and AFB positive in 7 patients, AFB and/or PGL-I in nerve in 6 patients. c) Nonspecific chronic inflammation in indeterminate leprosy presented as selective perineural and/or intraneural infiltration with lymphocytes predominating. In the infiltrating mass, fragments of neural tissue were demonstrated with anti-S-100 protein staining. d) Except for 3 cases with unknown numbers of lesions, the present positive immunohistopathological findings are in direct correlation with the number of lesions at first diagnosis, namely: 41.6% (10/24) for single lesion, 66.6% (6/9) for 2 lesions, and 88.8% (8/9) for patients with > or = 3 lesions. e) Typical epithelioid or macrophage granuloma formations were not seen in early leprosy with a single lesion. In testing the immunological inclination of these patients with CD68 or tumor necrosis factor-alpha (TNF-alpha) a positive test is likely to be of prognostic value since TNF-alpha is involved in granuloma formation and nerve damage.
authors.affiliation: Beijing Tropical Medicine Research Institute, 95 Yong-An Road, Beijing 100050, China.
authors.forename: X M
authors.initials: XM
authors.lastname: Weng
authors.forename: S Y
authors.initials: SY
authors.lastname: Chen
authors.forename: S P
authors.initials: SP
authors.lastname: Ran
authors.forename: C H
authors.initials: CH
authors.lastname: Zhang
authors.forename: H Y
authors.initials: HY
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000942:Antigens, Bacterial / Q000032:analysis; D015703:Antigens, CD / Q000032:analysis; D015214:Antigens, Differentiation, Myelomonocytic / Q000032:analysis; D001706:Biopsy; D001808:Blood Vessels / Q000382:microbiology; D002648:Child; D002681:China / Q000453:epidemiology; D006017:Glycolipids / Q000032:analysis; D006099:Granuloma / Q000276:immunology / Q000473:pathology; D006801:Humans; D007918:Leprosy / Q000453:epidemiology / Q000382:microbiology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009166:Mycobacterium leprae / Q000302:isolation & purification*; D009474:Neurons / Q000737:chemistry / Q000382:microbiology; D010523:Peripheral Nervous System Diseases / Q000276:immunology / Q000473:pathology; D009418:S100 Proteins / Q000032:analysis; D012867:Skin / Q000098:blood supply / Q000382:microbiology / Q000473:pathology; D017192:Skin Diseases, Bacterial / Q000382:microbiology* / Q000473:pathology; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D000097382:CD68 Molecule
chemical_list: D000942:Antigens, Bacterial; D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D006017:Glycolipids; D009418:S100 Proteins; D014409:Tumor Necrosis Factor-alpha; C067980:CD68 antigen, human; D000097382:CD68 Molecule; C045169:phenolic glycolipid I, Mycobacterium leprae