What are the findings of serologic studies 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...
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Answer

Recombinant K39 reactivity appears to correlate with active visceral disease caused by L donovani, L chagasi, and L infantum and is absent in cutaneous and mucocutaneous infections. Studies confirmed its diagnostic utility in India and Brazil but showed limited utility in Sudan because of regional species variance. [18, 19, 20] It is important to note that cross-reactions can occur with leprosy, Chagas disease, malaria, and schistosomiasis.

K39-based antigen testing is the only FDA-cleared rapid serologic test available that has undergone the necessary rigors of scientific testing to reliably trust for diagnosing visceral leishmaniasis. [21, 22]

DAT detects the specific immunoglobulin M (IgM) antibody at an early stage and has been found to be useful in the detection of both clinical and subclinical leishmaniasis infections. Because this test is easy to perform and the results are available in 24 hours, it can be used as a rapid test in primary care settings.

Before the use of specific leishmanial antigens, nonspecific antigens were used. These include the Witebsky, Kingenstein, Kuhn (WKK) antigen from the tubercle bacilli and an antigen from the Kedrowsky acid-fast bacillus. False-positive results occur in patients with tuberculosis, leprosy, and tropical Eosinophilia infection.


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