Rahman Simeen ber, Bari Arfan ul
Department of Dermatology, Military Hospital and Armed Forces Institute of Pathology, Rawalpindi.
J Coll Physicians Surg Pak. 2003 Jun;13(6):313-6.
To delineate the different laboratory findings in patients of cutaneous leishmaniasis and to see the efficacy of some recent immunodiagnostic tools in the diagnosis of disease.
Descriptive case-control study.
The study was conducted over a period of two years in Military Hospital (MH) and Armed Forces Institute of Pathology (AFIP), Rawalpindi, Pakistan.
Fifty patients with clinical diagnosis of cutaneous leishmaniasis(CL), were included in the study from western, south-western and northern regions of the country (Quetta, Multan, Chakwal, Kohat, Northern areas and Islamabad). Complete blood picture, blood groups, skin slit smears, impression smears and skin biopsies and serological tests including Enzyme-linked immunosorbent assay (ELISA), indirect fluorescent antibody test (IFAT), and indirect hemagglutination assay (IHA) were done in all cases. Immunohistochemistry with IFAT was performed in 20 patients and kDNA (kinetoplast DNA) probes in 16 patients. These tests were then evaluated to see their efficacy in diagnosis of CL.
Blood CP was normal except for low hemoglobin levels. Most prevalent blood group was B-positive. Skin slit smear and impression smears were positive in 30% and 36% cases respectively. On histopathology four distinct histological patterns emerged. Results with H&E, Giemsa and Leishman stains were similar (36%) and PAS failed to stain parasite. On tissue section IFAT yielded 36%, peroxidase-antiperoxidase (PAP) 45% and kDNA probes 25% positive results. Serology was positive in 56% with ELISA, in 50% each with IFAT and IHA tests.
Routine blood tests have no role in diagnosis of CL. Skin slit smear and touch impression smears are rapid means of diagnosis. Modern immunodiagnostic methods can produce better results but these are costly and availability is limited. In our setup slit skin smear/impression smear and light microscopy with routine H and E staining are probably the most co-effective accurate diagnostic methods.
描述皮肤利什曼病患者的不同实验室检查结果，并观察一些近期免疫诊断工具在该疾病诊断中的疗效。
描述性病例对照研究。
本研究在巴基斯坦拉瓦尔品第的军事医院（MH）和武装部队病理研究所（AFIP）进行，为期两年。
从该国西部、西南部和北部地区（奎达、木尔坦、查克拉瓦尔、科哈特、北部地区和伊斯兰堡）纳入50例临床诊断为皮肤利什曼病（CL）的患者。所有病例均进行了全血细胞计数、血型检测、皮肤刮片涂片、印片涂片、皮肤活检以及包括酶联免疫吸附测定（ELISA）、间接荧光抗体试验（IFAT）和间接血凝试验（IHA）在内的血清学检测。对20例患者进行了免疫组织化学IFAT检测，对16例患者进行了动基体DNA（kDNA）探针检测。然后评估这些检测在CL诊断中的疗效。
除血红蛋白水平较低外，血常规正常。最常见的血型是B阳性。皮肤刮片涂片和印片涂片的阳性率分别为30%和36%。组织病理学检查出现了四种不同的组织学模式。苏木精-伊红（H&E）、吉姆萨和利什曼染色的结果相似（36%），过碘酸希夫（PAS）染色未能显示寄生虫。在组织切片上，IFAT的阳性率为36%，过氧化物酶-抗过氧化物酶（PAP）为45%，kDNA探针为25%。ELISA血清学阳性率为56%，IFAT和IHA检测的阳性率均为50%。
常规血液检测对CL诊断无作用。皮肤刮片涂片和触片印片是快速诊断方法。现代免疫诊断方法可产生更好的结果，但成本高昂且可用性有限。在我们的研究中，皮肤刮片涂片/印片涂片和常规H&E染色光镜检查可能是最具成本效益的准确诊断方法。
