Leishmanin test in post-kala-azar dermal leishmaniasis

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TRANSACTIONS OF THEROYAL SOCIETY OF TROPICAL MEDICINEAND HYGIENE(1990)

1 Short Report

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Leishmanin test in post-kala-azar dermal leishmaniasis A. B. Neopy’, A. Nandy’ and A. B. Department of Zoology, B.S. College, Chowdhur$

Canning, West Bengal, India; zDivision of Parasitology, Calcutta School of Tropical Medicine, C.R. Avenue, Calcutta, -700073, India

Although the leishmanin test has been recommended as an important indicator for delayed hypersensitivity to leishmanin antigen in kala-azar (MAUEL & BEHIN, 1982), the test is yet to be evaluated conclusiv&y in post-kala-azar de&al leishmaniasis (PKDL). MANSON-BAHR (1959) observed that 3 o
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whereas induration on the non-kala-azar cases, if present at all, was always less than 5 mm in diameter. Contrary to the observation made by others, all the PKDL patients were leishmanin-negative before the treatment was started. At the same time all the cured kala-azar patients were positive. None of the subjects showed any induration on the control (phenol) forearm. Interestingly, PKDL patients remained leishmanin-negative even after 4 months, when appreciable clinical response was evident. It was only after 8 months that positive reactions were recorded, and then in only 3 of 10 patients. Our previous study (NEOGY et al.. 1988) recorded satisfactorv develooment of cell-media&d immune responses-(indicated by in vitro tests like lymphoblast transformation, leucocyte migration inhibition, etc.) commensurate with clinical improvement after 6 months of treatment. The lack of leishmanin positivity in many of the present PKDL patients even after clinical cure is difficult to explain, particularly its seeming lack of correlation with other indicators of cell-mediated immune response. However, it will be interesting to know the results of a longer follow-up period. References Haldar. I. P.. Ghose. S.. Saha. K. C. & Ghose. A. C. 11983). Celi inediated in&&e response in Indian’kala-a& ar;d post kala-azar dermal leishmaniasis. Infection and Zmmunity, 42, 702-707. Manson-Bahr, P. C. C. (1959). Studies in leishmaniasis in East Africa. IV. The Montenegro test in kala-azar in Kenya. Transactions of the Royal Society of Tropical Medicine and Hygiene, 53, 380-383.

Mauel, J. & Behin, R. (1982). Leishmaniasis: immunity, immunopathology and immunodiagnosis. In: Immunity to Parasitic Infections, Cohen, S. & Warren, K. S. (editors), Oxford, etc.: Blackwell Scientific Publications, DD. 34%363. Nidy, A., Neogy, A. B. & Chowdhury, A. B. (1987). Lelshmanin test survey in an endemic village of Indian kala-azar near Calcutta. Annals of Tropical Medicine and Parasitology, 81, 693-699. Neogy, A. B., Nandy, A., Ghosh-Dastidar, B. & Chowdhury, A. B. (1986). Leishmanin test in Indian kala-azar.

Transactions of the Royal Society of Tropical Medicine and Hygiene, 80, 454-455. Neogy, A. B., Nandy, A., Ghosh-Dastidar, B. & Chow-

dhury, A. B. (1988). Modulation of the cell-mediated imm&e response inkala-azar and post kala-azar dermal leishmaniasis in relation to chemotherapy. Annals of Tropical Medicine and Parasitology, 82, 27-34.

Sen-Gupta, P. C. St Mukherjee, A. M. (1962). Intradermal test with Leishmania donovani antigen in post kala-azar dermal leishmaniasis. Annals of Biochemisttyand Experimental Medicine, 22, 63-66.

Received 23 May 1989; revised 24 July 1989; accepted for publication 25 July 1989