Which ancillary lab tests are indicated in the workup of leishmaniasis?

Updated: Feb 18, 2020
  • Author: Craig G Stark, MD, FACP, FFTM, RCPS(Glasg), FISTM; Chief Editor: Pranatharthi Haran Chandrasekar, MBBS, MD  more...
  • Print
Answer

Hypogammaglobinemia, circulating immune complexes, and rheumatoid factors are present in sera of most patients with visceral leishmaniasis. Rarely, immunocomplex deposition in the kidneys may lead to mild glomerulonephritis. However, renal failure is not a feature of visceral leishmaniasis.

Ancillary tests important in the diagnosis of visceral disease include measurements of lipase, amylase, gamma globulin, and albumin.

The aldehyde test and the antimony test were the initial tests used to detect hypogammaglobinemia and diagnose visceral leishmaniasis. Findings include elevated gamma globulin levels and a reversal of the albumin-globulin ratio.

For the aldehyde test, obtain approximately 1 mL of blood in a small glass tube, and add 1-2 drops of 40% formalin. The formation of milky whitelike opacity and jellification indicates a positive result. Aldehyde test findings are not positive unless the disease has been present for at least 3 months.

Antimony test findings also depend on a rise in serum gamma globulin levels. Positive findings are indicated by a white flocculent precipitate that is observed when a urea stibamine solution comes in contact with serum.


Did this answer your question?
Additional feedback? (Optional)
Thank you for your feedback!