Assessment of the diagnostic value of immunocytochemitsry and in situ hybridization in cytological specimen of childhood leprosy

Authors

  • Mohd. Parvez Department of Pediatrics, IIMSR, Lucknow, Uttar Pradesh, India
  • R. Dayal Department of Pediatrics, SNMC, Agra, Uttar Pradesh, India
  • M. Natrajan Department of Clinical Medicine, JALMA, Agra, Uttar Pradesh, India
  • Raj Kamal Department of Clinical Medicine, JALMA, Agra, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20184216

Keywords:

Immunocytochemistry, In situ hybridization, Leprosy

Abstract

Background: Hardly any studies have been done to study diagnostic value of immunocytochemistry and in situ hybridization in cytological specimens for the diagnosis of leprosy in children. The objective of this study is to assess the diagnostic value of immunocytochemistry and in situ hybridization in cytological specimens of leprosy patients. To compare these techniques with Z.N. staining.

Methods: This prospective study was carried out in 24 patients (≤18 years of age) of leprosy. Clinical examination of each patient was done and categorized according to IAL. After taking consent, three skin smears was taken, one for Z.N. staining and remaining two for immunocytochemistry and in situ hybridization respectively.

Results: Routine skin smear examination by ZN staining method confirmed the diagnosis in 2/24 (8.3%) cases and they belonged to BL category. Immunocytochemistry showed positivity in 4/7 (57.1%) in early leprosy (BT) and 82.3% (BB/BL) in late leprosy. Immunocytochemistry improved the diagnosis by 66.7%, and the results were statistically significant (p<0.01). In situ hybridization showed the positive results in 66.6% cases of early leprosy and 86.6% cases of late leprosy (BB/BL). In situ hybridization improved the diagnosis 72.6% in comparison to ZN staining and the results were statistically significant (p<0.01).

Conclusions: Immunocytochemistry and in situ hybridization enhance the diagnosis of leprosy when compared to routine skin smears stained by ZN staining. They are important diagnostic tools for definitive diagnosis in early as well as established cases of leprosy.

References

WHO. Diagnosis of leprosy. 2011. Available at www.who.int/lep/diagnosis/en/index.

Fine PE, Job CK, McDougall AC, Meyers WM, Ponnighaus JM. Comparability among histopathologists in the diagnosis and classification of lesions suspected of leprosy in Malawi. Int J Lepr. 1986;54:614-25.

Ramu G, Karthikeyan S, Balakrishanan S. Histological and Immunological correlation of suspected leprosy patients. Indian J Lepr. 1996;68: 153.

Wang XM, Chan SY, Ran SP. Immunohistopathology in the diagnosis of early leprosy. Int J Lepr. 2000;68:426-9.

Natrajan M, Katoch K, Katoch VM. Histology and immuno-histology of lesions clinically suspicious of leprosy. Acta leprologica. 1999;11(3):93-8.

Dayal R, Agarwal M, Natrajan M, Katoch VM, Katoch K, Singh K. PCR and in-situ hybridization for diagnosis of leprosy. Indian J Pediatr. 2007;74(7):645-8.

Dharmendra. Classification of leprosy. In: Hastings RC, Convit J, Eds. Leprosy. Churchill Livingstone, Edinburgh; 1985:88-99.

Dayal R, Gupta R, Mathur PP, Dhir GG, Katoch VM, Katoch K. Study of gene probes in childhood leprosy. Ind J Pediatr.1997;65:99-105.

Dave MS, Agarwal SK. Prevalence of leprosy in children of Leprosy patients. Lepr India. 1984;56:615-21.

Dayal R, Hashmi NA, Mathur PP, Prasad R. Leprosy in children. Indian Pediatr. 1990;27:170-80.

Dayal R, Agrawal PK, Kalra K, Bhardwaj VP, Katoch VM, Katoch K. Diagnostic value of gene probes and its correlation with clinical profile of leprosy in Children. Indian Pediatr. 1994;31:1521-7.

Natrajan M, Katoch K, Katoch VM. Increase in the sensitivity of immunohistochemical procedure by end product amplification demonstrated on tissue specimens of clinically suspect leprosy. Indian J Lepr. 2003;76:64-5.

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Published

2018-10-22

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Original Research Articles