Comparison of new diagnostic tools for management of pediatric Mediterranean visceral leishmaniasis
Comparison of new diagnostic tools for management of pediatric Mediterranean visceral leishmaniasis
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DOI：
10.1128/jcm.02297-05
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发表时间：
2006-07-01
影响因子：
9.4
通讯作者：
Alvar, Jorge
中科院分区：
文献类型：
--
作者：
Cruz, Israel;Chicharro, Carmen;Alvar, Jorge
新技术可用于诊断利什曼病。但其在鉴别儿童内脏利什曼病（VL）中的功效尚未与传统方法进行比较。血骨髓和尿液样本取自25名VL儿童在他们的第一次临床发作。在开始用脂质体阿替霉素B（3 mg/kg/天，在10天的时间段内6天）处理后22天。以及在随访期间怀疑复发的时间。结果表明，抗体检测技术、尿抗原检测（KAtex试剂盒）和血液利什曼原虫巢式PCR（LnPCR）分析可用于首次临床发作的诊断。治疗后，临床改善与Novy-MacNeal-Nicolle培养阴性和骨髓穿刺液显微镜检查相关。KAtex测试。和LnPCR血液分析结果。有趣的是，骨髓穿刺液的LnPCR分析显示，8名患者未实现无菌治愈，其中2名患者在10至20周内复发。所有测试的新的非侵入性技术都显示出很高的诊断灵敏度。然而.骨髓的LnPCR分析是最敏感的;该测试能够检测寄生虫的持续性并预测潜在的复发。
New techniques are available for diagnosing leishmaniasis. but their efficacy in the identification of pediatric visceral leishmaniasis (VL) has not been compared with that of traditional methods. Blood. bone marrow, and urine samples were taken from 25 children with VL during their first clinical episode. 22 days after the start of treatment with liposomal amphotericin B (3 mg/kg/day on 6 days over a 10-day period). and when a relapse was suspected during follow-up. The results obtained suggest that antibody detection techniques, the antigen detection in urine (KAtex kit), and Leishmania nested PCR (LnPCR) analysis of the blood could be used for diagnosis of the first clinical episode. After treatment, clinical improvement was associated with negativization of Novy-MacNeal-Nicolle culture and microscopy of bone marrow aspirate. KAtex test. and LnPCR blood analysis results. Interestingly, LnPCR analysis of the bone marrow aspirate showed that sterile cure was not achieved in eight patients, two of which suffered a relapse within 10 to 20 weeks. All of the new noninvasive techniques tested showed high diagnostic sensitivity. However. LnPCR analysis of the bone marrow was the most sensitive; this test was able to detect the persistence of parasites and predict potential relapses.