RESUMO
1. We have studied some generic and specific aspects of the humoral immune response in 96 patients with leprosy (29 paucibacillary and 67 multibacillary individuals). We determined serum immunoglobulins (IgM, IgG and IgA), CH50, C1q, C3 and C4, circulating immune complexes (CIC), C-reactive protein (CRP), rheumatoid factor (RF) and antinuclear antibodies. No specific pattern of general humoral immune changes could be observed. 2. The specific immune response was studied by the detection of specific IgM anti-M. leprae antibodies. An immunoradiometric assay (IRMA) and an ELISA were compared for clinical effectiveness. IRMA showed greater sensitivity for the serodiagnosis of leprosy as compared to ELISA (88.1% vs 58.2% for multibacillary patients and 20.7% vs 10.3% for paucibacillary leprosy patients). Specificity was 96% for IRMA and 97% for ELISA. 3. Our results indicate that nonspecific changes in the humoral immune response are of little value in assessing leprosy patients and that immune assays for the detection of specific anti-M. leprae antibodies may be of value in the diagnosis, study and follow-up of these patients.
Assuntos
Anticorpos Antibacterianos/análise , Hanseníase/imunologia , Mycobacterium leprae/imunologia , Adolescente , Adulto , Idoso , Anticorpos Antinucleares , Proteína C-Reativa , Criança , Feminino , Interações Hospedeiro-Parasita , Humanos , Hanseníase/diagnóstico , Hanseníase Virchowiana/diagnóstico , Hanseníase Virchowiana/imunologia , Masculino , Pessoa de Meia-Idade , Fator Reumatoide/imunologia , Sensibilidade e EspecificidadeRESUMO
1. We have studied some generic and specific aspects of the humoral immune response in 96 patients with leprosy (29 paucibacillary and 67 multibacillary individuals). We determined serum immunoglobulins (IgM, IgG and IgA), CH50, C1q, C3 and C4, circulating immune complexes (CIC), C-reactive protein (CRP), rheumatoid factor (RF) and antinuclear antibodies. No specific pattern of general humoral immune changes could be observed. 2. The specific immune response was studied by the detection of specific IgM anti-M. leprae antibodies. An immunoradiometric assay (IRMA) and an ELISA were compared for clinical effectiveness. IRMA showed greater sensitivity for the serodiagnosis of leprosy as compared to ELISA (88.1 percent vs 58.2 percent for multibacillary patients and 20.7 percent vs 10.3 percent for paucibacillary leprosy patients). Specificity was 96 percent for IRMA and 97 percent for ELISA. 3. Our results indicate that nonspecific changes in the humoral immune response are of little value in assessing leprosy patients and that immune assays for the detection of specific anti-M. leprae antibodies may be of value in the diagnosis, study and follow-up of these patients
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Pessoa de Meia-Idade , Anticorpos Antibacterianos/análise , Ensaio de Imunoadsorção Enzimática , Hanseníase/imunologia , Ensaio Imunorradiométrico , Mycobacterium leprae/imunologia , Anticorpos Antinucleares , Proteína C-Reativa , Seguimentos , Hanseníase/diagnóstico , Hanseníase Virchowiana/diagnóstico , Hanseníase Virchowiana/imunologia , Interações Hospedeiro-Parasita , Sensibilidade e EspecificidadeAssuntos
Adolescente , Anticorpos Antibacterianos/análise , Anticorpos Antinucleares , Criança , Fator Reumatoide/imunologia , Hanseníase Virchowiana/diagnóstico , Hanseníase Virchowiana/imunologia , Hanseníase/diagnóstico , Hanseníase/imunologia , Interações Hospedeiro-Parasita , Mycobacterium leprae/imunologia , Proteína C-Reativa , Sensibilidade e EspecificidadeRESUMO
We have evaluated laboratory and clinical manifestations of renal disease in 96 patients with leprosy, looking for a sensitive and early marker for detection and possibly follow-up of nephropathy in these patients. Microscopic hematuria was observed in 21.9% of the cases (with dysmorphic erythrocytes in 71.4% of them). Abnormal microalbuminuria and urinary beta 2-microglobulin were found in 15.8 and 19.8% of the cases, respectively. We have observed a high frequency of hematuria, abnormal microalbuminuria and elevation of urinary beta 2-microglobulin in these patients still with normal serum creatinine.
Assuntos
Nefropatias/etiologia , Hanseníase/complicações , Adolescente , Adulto , Idoso , Albuminúria/etiologia , Biomarcadores/urina , Criança , Creatinina/sangue , Feminino , Hematúria/etiologia , Humanos , Nefropatias/diagnóstico , Nefropatias/urina , Hanseníase/sangue , Hanseníase/urina , Masculino , Pessoa de Meia-Idade , Microglobulina beta-2/urinaRESUMO
despite the high frequency of renal involvement associated with Hansen's disease and the persistent occurrence of leprosy, especially in the underveloped countries, reference to kidney transplantation in these patients is rare. Secondary amyloidosis and a nephritic process possibly mediated by immune complexes are present in one-half of the leprosy pateints studied either by autopsy or by kidney biopsy.