title: Application of Mycobacterium Leprae-specific cellular and serological tests for the differential diagnosis of leprosy from confounding dermatoses.
abstract: 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.
authors: Tropical Pathology and Public Health Institute, Federal University of Goiás, Goiânia, Brazil.
authors: Aline Araújo
authors: AA
authors: Freitas
authors: Tropical Pathology and Public Health Institute, Federal University of Goiás, Goiânia, Brazil.
authors: Emerith Mayra
authors: EM
authors: Hungria
authors: Tropical Pathology and Public Health Institute, Federal University of Goiás, Goiânia, Brazil.
authors: Maurício Barcelos
authors: MB
authors: Costa
authors: Tropical Pathology and Public Health Institute, Federal University of Goiás, Goiânia, Brazil.
authors: Ana Lúcia Osório Maroccolo
authors: AL
authors: Sousa
authors: Hospital of Tropical Diseases (Hospital de Doenças Tropicais Dr Anuar Auad HDT/HAA), Goiânia, Goiás, Brazil.
authors: Mirian Lane Oliveira
authors: ML
authors: Castilho
authors: Centro de Dermatologia Dona Libânia (CDERM), Fortaleza, Ceará, Brazil.
authors: Heitor Sá
authors: HS
authors: Gonçalves
authors: Centro de Dermatologia Dona Libânia (CDERM), Fortaleza, Ceará, Brazil.
authors: Maria Araci Andrade
authors: MA
authors: Pontes
authors: Infectious Disease Research Institute (IDRI), Seattle, WA, USA.
authors: Malcolm S
authors: MS
authors: Duthie
authors: Tropical Pathology and Public Health Institute, Federal University of Goiás, Goiânia, Brazil. Electronic address: mmastefani@gmail.com.
authors: Mariane Martins Araújo
authors: MM
authors: Stefani
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D003955:Diagnostic Tests, Routine / Q000379:methods*; D005260:Female; D006801:Humans; D007118:Immunoassay / Q000379:methods*; D007918:Leprosy / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009166:Mycobacterium leprae / Q000276:immunology*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012871:Skin Diseases / Q000175:diagnosis*; D055815:Young Adult
keywords: Cellular immunity; Differential diagnosis of leprosy; Leprosy; Other dermatoses; Serology