de Godoy Natalia Souza, Andrino Marcos Luiz Alves, de Souza Regina Maia, Gakiya Erika, Amato Valdir Sabbaga, Lindoso José Ângelo Lauletta, Almeida Braz Lucia Maria
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.
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.
J Parasitol Res. 2016;2016:1084353. doi: 10.1155/2016/1084353. Epub 2016 Aug 14.
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.
本研究的目的是评估外周血中的分子诊断（kDNA-PCR）和寄生虫学诊断能否替代侵入性且痛苦的骨髓采集用于内脏利什曼病（VL）的诊断。以临床、流行病学和免疫层析试验（PB-rK39）结果及骨髓寄生虫学检查的组合作为金标准（GS），对疑似VL患者的外周血进行寄生虫学和分子技术评估。根据GS，将32例患者的38份样本分组：第1组为20份VL病例样本，第2组为18份非VL病例样本。为评估外周血中的寄生虫学和分子技术，对样本进行了检测。第1组中，外周血kDNA-PCR在20份样本中呈阳性，骨髓kDNA-PCR检查在20份样本中的19份呈阳性。然而，血沉棕黄层的寄生虫学检查不敏感，仅能检测出第1组中的4例。第2组的所有样本均为阴性。我们得出结论，对于内脏利什曼病的诊断，外周血寄生虫学检查无用；然而，在外周血中进行的kDNA-PCR分子诊断可用于替代骨髓寄生虫学检查。
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