1 research outputs found
Diagnostic usefulness of immunohistochemical evaluation of CD1a antigen and polyclonal antiLeishmania antibodies in cutaneous Leishmaniasis
Background. Different immunohistochemical
markers to detect amastigotes in cutaneous
Leishmaniasis have been proposed with variable
diagnostic usefulness.
Objectives. To evaluate the diagnostic usefulness of
immunohistochemical amastigotes identification by
specific polyclonal anti-Leishmania antibodies and
CD1a expression (clone EP3622) in a series of PCR
confirmed cutaneous Leishmaniasis.
Materials and methods. Thirty-three skin samples
corresponding to PCR confirmed cutaneous
Leishmaniasis were included in the study. All samples
were stained with Hematoxylin-eosin and Giemsa.
Moreover, immunohistochemical studies with anti-CD1a
and anti-Leishmania antibodies were performed. The
patients clinical features and the observed
histopathological features were also recorded.
Results. From the selected 33 biopsies, Leishmania
spp. amastigotes were detected in 48.4% of cases with
conventional Hematoxylin-eosin stain and in 57.5% of
cases by Giemsa staining. In 31/33 cases, anti-CD1a
allowed us to identify parasitic structures, and in 33/33
cases amastigotes were detected with anti-Leishmania
antibodies. Concordance between both techniques, antiCD1a and anti-Leishmania, was 94% [CI 95%: (79,8%-
99,3%)]; p value <0.05. The sensitivity of anti-CD1a in
comparison with the PCR was 94%, with a positive
predictive value of 100%. Two cases of low parasitic
index were negative for CD1a immunostaining. In cases
with high parasitic index, anti-CD1a stained amastigotes
in superficial and deep dermis. Only a few cases were
originally diagnosed with the available histological
techniques, needing PCR for Leishmania spp.
identification.
Conclusions. Anti-CD1a antibody seems to be a
useful technique to identify amastigotes when PCR and
anti-Leishmania antibodies are not available. The
sensitivity to detect amastigotes is increased when the
CD1a immunostaining is added to the classical
Haematoxylin – eosin and Giemsa staining