Diagnosis of toxoplasmosis in bone marrow transplant recipients:: comparison of PCR-based results and immunohistochemistry

被引:41
作者
Held, TK
Krüger, D
Switala, AR
Beyer, J
Kingreen, D
Busemann, C
Janitschke, K
Siegert, W
机构
[1] Humboldt Univ, Klin Innere Med Schwerpunkt Hamatol & Onkol, D-13353 Berlin, Germany
[2] Humboldt Univ, Inst Pathol, D-13353 Berlin, Germany
[3] Robert Koch Inst, Projekt Parasitol Mykol, D-1000 Berlin, Germany
[4] Univ Marburg, Hamatol Abt, Marburg, Germany
关键词
toxoplasmosis; bone marrow transplantation; PCR; immunohistochemistry; serology;
D O I
10.1038/sj.bmt.1702457
中图分类号
Q6 [生物物理学];
学科分类号
071011 ;
摘要
Toxoplasmosis in bone marrow transplant recipients is a rare but serious complication and if untreated, almost uniformly fatal. The diagnosis, however, remains difficult. We therefore compared serial determination of antibody titers specific for T. gondii before and after transplantation, serial PCR for T. gondii DNA in serum, PCR and nested PCR for T. gondii DNA in various tissues, conventional histology and immunohistochemistry for detection of parasites in three patients with autopsy-confirmed toxoplasmosis after bone marrow transplantation. Immunohistochemistry demonstrated the presence of parasites in 13 out of 20 organs investigated (65%), whereas PCR detected T. gondii-specific DNA in 15 out of 20 organs (75%). Immunohistochemistry revealed concordant results to PCR data in 60% of the specimens. With the use of a nested PCR protocol, eight out of nine samples (89%) were positive for T. gondii-specific DNA. The combination of both methods detected the presence of parasites in 90% of the specimens. Serial PCR in serum did not yield positive results. Neither PCR nor immunohistochemistry was able to detect parasites in all organs investigated, but both methods together improved sensitivity to 90% and consequently, should he used jointly to maximize diagnostic precision.
引用
收藏
页码:1257 / 1262
页数:6
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