Home Medicine 2.12 Microalbuminuria and urinary retinol binding protein as markers of subtle renal injury in visceral leishmaniasis: sensitivity, specificity and predictive values of the immunoturbidimetric technique
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2.12 Microalbuminuria and urinary retinol binding protein as markers of subtle renal injury in visceral leishmaniasis: sensitivity, specificity and predictive values of the immunoturbidimetric technique

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652.12 Microalbuminuria and urinary retinol binding protein as markers of subtle renal injury in visceral leishmaniasis: sensitivity, specifi city and predictive values of the immunoturbidimetric techniqueNuha A.A. Elnojomi, Ahmed M. Musa, Brima M. Younis, Mohammed E. Elfaki, Ahmed M. El-Hassan and Eltahir A. KhalilSummaryLeishmania donovani-related visceral leishmaniasis (VL) is endemic over large areas of Sudan. It is a serious febrile illness and is characterized by fever, hepatosplenom-egaly, lymph adenopathy, pancytopenia, and renal injury. Microalbuminuria (MA) and urinary retinol binding protein (urRBP) are useful markers for glomerular and tubular dysfunctions, respectively. Paromomycin®, an amino glycoside antibiotic that is under assessment as an alternative treatment for VL, is known to be nephrotoxic. The nephro-toxicity is dose related. We report the frequency of subtle renal affection of VL and Paro-momycin treatment in 46 parasitologicaly-confi rmed VL patients enrolled for random treatment with different Paromomycin doses (15 mg/kg/day for 28 days or 20 mg/kg/day for 21 days) in a prospective, hospital-based and comparative study. We introduce the turbidimetric measurement for MA as a simple and fi eld-based technique. Blood and urine were collected before and after treatment for hematological, biochemical profi les in addition to MA and urRBP measurement using competitive solid-phase, sandwich enzyme-linked immune sorbent assay (ELISA), and immunoturbidimetry. All patients (46/46; 100%) had normal serum urea and creatinine levels. More than 50% of patients had pretreatment MA detected by ELISA, whereas 54% were reactive with turbidimetry. Of the 46 patients, 4.3% had pre-urRBP detected by ELISA. Post-treatment MA was seen in more than 80% of patients who were treated with 20 mg/kg/day for 21 days Paromomycin while all of the patients who were treated with 15 mg/kg/day lost their pre-treatment reactivity. The sensitivity, specifi city, positive and negative predictive val-ues for MA using the turbidimetric technique were calculated as 100%, 86%, 85% and 100%, respectively. In conclusion, subtle renal injury in VL is mainly glomerular. Use of the 20 mg/kg/day Paromomycin should be critically investigated before implementation in routine use. Turbidimetry for MA measurement is a simple inexpensive, sensitive, and specifi c technique with high predictive values.IntroductionThe leishmaniases are a globally widespread group of parasitic diseases caused by a fl agellate protozoa belonging to the genus Leishmania. The spectrum of infection with

652.12 Microalbuminuria and urinary retinol binding protein as markers of subtle renal injury in visceral leishmaniasis: sensitivity, specifi city and predictive values of the immunoturbidimetric techniqueNuha A.A. Elnojomi, Ahmed M. Musa, Brima M. Younis, Mohammed E. Elfaki, Ahmed M. El-Hassan and Eltahir A. KhalilSummaryLeishmania donovani-related visceral leishmaniasis (VL) is endemic over large areas of Sudan. It is a serious febrile illness and is characterized by fever, hepatosplenom-egaly, lymph adenopathy, pancytopenia, and renal injury. Microalbuminuria (MA) and urinary retinol binding protein (urRBP) are useful markers for glomerular and tubular dysfunctions, respectively. Paromomycin®, an amino glycoside antibiotic that is under assessment as an alternative treatment for VL, is known to be nephrotoxic. The nephro-toxicity is dose related. We report the frequency of subtle renal affection of VL and Paro-momycin treatment in 46 parasitologicaly-confi rmed VL patients enrolled for random treatment with different Paromomycin doses (15 mg/kg/day for 28 days or 20 mg/kg/day for 21 days) in a prospective, hospital-based and comparative study. We introduce the turbidimetric measurement for MA as a simple and fi eld-based technique. Blood and urine were collected before and after treatment for hematological, biochemical profi les in addition to MA and urRBP measurement using competitive solid-phase, sandwich enzyme-linked immune sorbent assay (ELISA), and immunoturbidimetry. All patients (46/46; 100%) had normal serum urea and creatinine levels. More than 50% of patients had pretreatment MA detected by ELISA, whereas 54% were reactive with turbidimetry. Of the 46 patients, 4.3% had pre-urRBP detected by ELISA. Post-treatment MA was seen in more than 80% of patients who were treated with 20 mg/kg/day for 21 days Paromomycin while all of the patients who were treated with 15 mg/kg/day lost their pre-treatment reactivity. The sensitivity, specifi city, positive and negative predictive val-ues for MA using the turbidimetric technique were calculated as 100%, 86%, 85% and 100%, respectively. In conclusion, subtle renal injury in VL is mainly glomerular. Use of the 20 mg/kg/day Paromomycin should be critically investigated before implementation in routine use. Turbidimetry for MA measurement is a simple inexpensive, sensitive, and specifi c technique with high predictive values.IntroductionThe leishmaniases are a globally widespread group of parasitic diseases caused by a fl agellate protozoa belonging to the genus Leishmania. The spectrum of infection with

Chapters in this book

  1. Frontmatter i
  2. Preface v
  3. Table of Contents vii
  4. Authors Index xi
  5. 1 Plenary Articles
  6. 1.1 Proteomics strategies targeting biomarkers for cardiovascular disease 3
  7. 1.2 Influence of pre-examination aspects on result’s validity – are ISO 15189 requirements sufficient and clear? 9
  8. 1.3 Posttranslational modifications in tumor diagnosis 12
  9. 1.4 Chronic inflammatory disease: a result of complex gene-environment interaction 16
  10. 2 Symposium Articles
  11. 2.1 Component-array technology diagnostics: a step forward in the study of the sensitization profile of allergic patients 23
  12. 2.2 Pediatric metabolic syndrome: pathophysiology and molecular mechanisms 26
  13. 2.3 Urinary 8-hydroxydeoxyguanosine as a biomarker of microangiopathic complications in type 2 diabetic patients 30
  14. 2.4 Biological variation data: the need for appraisal of the evidence base 35
  15. 2.5 Recovery ELISA – a newly-developed immunoassay for measurement of therapeutic antibodies and the target antigen during antibody therapy 38
  16. 2.6 Genotypic prediction of HIV-1 tropism from plasma and peripheral blood mononuclear cells in the clinical routine laboratory 42
  17. 2.7 Expression of a subset of microRNAs in clinically non-functioning pituitary adenomas correlates with tumor size 46
  18. 2.8 Serological markers of gastric pathology 50
  19. 2.9 BNP as a biomarker of cardiac impairment in neonates with congenital heart diseases 54
  20. 2.10 Are 25-hydroxyvitamin D assays fit for purpose? 58
  21. 2.11 Update on multiple sclerosis 61
  22. 2.12 Microalbuminuria and urinary retinol binding protein as markers of subtle renal injury in visceral leishmaniasis: sensitivity, specificity and predictive values of the immunoturbidimetric technique 65
  23. 2.13 Occult hepatitis B virus infection: diagnosis and significance 68
  24. 2.14 Unmet needs in chronic kidney disease testing 72
  25. 2.15 Towards a national chronic kidney disease testing program 75
  26. 2.16 Biochemistry and metabolism of vitamin D 78
  27. 2.17 Diagnostics of thalassemia 82
  28. 2.18 The specific roles of assessors during accreditation 85
  29. 2.19 Laboratory diagnosis of hereditary spherocytosis 88
  30. 2.20 Quantification of blood folate forms using stable-isotope dilution ultra performance liquid chromatography tandem mass spectrometry 91
  31. 2.21 Evaluation of the new Marburg cerebrospinal fluid model with human spondylopathies 95
  32. 2.22 E-learning experiences of national societies of clinical chemistry and laboratory medicine 99
  33. 2.23 The experience of Médecins Sans Frontières in laboratory medicine in resource-limited settings 102
  34. 2.24 Screening, identifying, and quantifying small molecules by hyphenated mass spectrometry in toxicology and drug monitoring – an update 108
  35. 2.25 Analytical quality in the Latin America area 111
  36. 2.26 Standardization in molecular diagnostics: definitions and uses of nucleic acid reference materials 116
  37. 2.27 Profiling of antiphospolipid antibodies – association with cerebrovascular events in APS 120
  38. 2.28 Plasma levels of soluble CD30 and CD40L in pediatric patients after liver transplantation 124
  39. 2.29 Diagnostic and prognostic value of presepsin (soluble CD14 subtype) in emergency patients with early sepsis using the new assay PATHFAST presepsin 128
  40. 2.30 Diagnostic workup of primary aldosteronism 134
  41. 2.31 What should the clinical laboratory and the toxicologist-pharmacologist offer the poisoned patient? 138
  42. 2.32 Novel aspects of the von Willebrand factor – platelet glycoprotein IB interaction and signaling 142
  43. 2.33 Medical emergencies: what is the laboratory’s role? 143
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