Could kDNA-PCR in Peripheral Blood Replace the Examination of Bone Marrow for the Diagnosis of Visceral Leishmaniasis?
The aim of this study was to evaluate whether the molecular (kDNA-PCR) and parasitological diagnosis in peripheral blood (PB) could replace the invasive and painful bone marrow collection (BM) in the diagnosis of visceral leishmaniasis (VL). PB from suspected VL patients was evaluated by parasitological and molecular techniques using as the gold standard (GS) a combination of clinical, epidemiological, and immunochromatographic test (PB-rK39) results and parasitological examination of BM. Based on the GS, 38 samples from 32 patients were grouped: Group 1, 20 samples of VL cases, and Group 2, 18 samples of non-VL cases. In order to evaluate the parasitological and molecular techniques in PB, the samples were examined. From Group 1, PB kDNA-PCR was positive in 20 samples and in 19 of 20 in BM kDNA-PCR examination. However, the parasitological examination of buffy coat was insensitive, being able to detect only 4 cases from Group 1. All samples from Group 2 were negative. We concluded that, for the diagnosis of visceral leishmaniasis, the parasitological examination of peripheral blood was not useful; however, molecular diagnosis by kDNA-PCR, performed in peripheral blood, could be useful to replace the parasitological examination of bone marrow.
Laboratório de Investigação Médica, Parasitologia LIM 46 do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Avenida Dr. Enéas Carvalho de Aguiar 470/500, 05403-000 São Paulo, SP, Brazil.
Natalia Souza
NS
de Godoy
Laboratório de Investigação Médica, Parasitologia LIM 46 do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Avenida Dr. Enéas Carvalho de Aguiar 470/500, 05403-000 São Paulo, SP, Brazil.
Marcos Luiz Alves
ML
Andrino
Laboratório de Investigação Médica, Parasitologia LIM 46 do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Avenida Dr. Enéas Carvalho de Aguiar 470/500, 05403-000 São Paulo, SP, Brazil.
Regina Maia
RM
de Souza
Laboratório de Investigação Médica, Parasitologia LIM 46 do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Avenida Dr. Enéas Carvalho de Aguiar 470/500, 05403-000 São Paulo, SP, Brazil.
Erika
E
Gakiya
Laboratório de Investigação Médica, Parasitologia LIM 46 do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP), Avenida Dr. Enéas Carvalho de Aguiar 470/500, 05403-000 São Paulo, SP, Brazil; Departamento de Moléstias Infecciosas e Parasitárias, HCFMUSP, Avenida Dr. Enéas Carvalho de Aguiar 255, 05403-000 São Paulo, SP, Brazil.
Valdir Sabbaga
VS
Amato
Laboratório de Soroepidemiologia e Imunobiologia, IMTSP-USP, Avenida Dr. Enéas Carvalho de Aguiar 470/500, 05403-000 São Paulo, SP, Brazil; Hospital Emilio Ribas, Avenida Dr. Arnaldo 165, 01246-900 São Paulo, SP, Brazil.
José Ângelo Lauletta
JÂ
Lindoso
Laboratório de Parasitologia, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo (IMTSP-USP), Avenida Dr. Enéas Carvalho de Aguiar 470/500, 05403-000 São Paulo, SP, Brazil.
Lucia Maria
0000-0002-6493-465X
LM
Almeida Braz