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Immunofluorescence testing in the diagnosis of autoimmune blistering diseases: overview of 10-year experience.

Arbache ST, Nogueira TG, Delgado L, Miyamoto D, Aoki V - An Bras Dermatol (2014 Nov-Dec)

Bottom Line: In group 2, positive DIF findings included multiple deposits at basement membrane zone for epidermolysis bullosa acquisita-EBA (C3-89%,IgG-79%,IgA-47%,IgM-21%) mucous membrane pemphigoid-MMP (C3,IgG,IgA,IgM-80%) and bullous pemphigoid-BP (C3-91%,IgG-39%,IgA-11%,IgM-6%), and IgA at basement membrane zone for IgA linear disease (99%) and dermatitis herpetiformis-DH (dermal papillae in 84.6%).For lichen planus pemphigoides, there was C3 (100%) and IgG (50%) deposition at basement membrane zone. indirect immunofluorescence positive findings revealed basement membrane zone IgG deposits in 46% of BP patients, 50% for EBA, 15% for IgA linear dermatosis and 50% for LPP.Indirect immunofluorescence positive results were higher for BP and EBA with Salt-Split skin substrate.

View Article: PubMed Central - PubMed

Affiliation: Universidade de São Paulo, São Paulo, SP, Brazil.

ABSTRACT

Background: Immunofluorescence testing is an important tool for diagnosing blistering diseases.

Objective: To characterize the immunofluorescence findings in patients diagnosed with autoimmune blistering skin diseases.

Methods: We retrospectively analyzed immunofluorescence results encompassing a 10-year period.

Results: 421 patients were included and divided into 2 groups: group 1- intraepidermal blistering diseases (n=277) and 2- subepidermal blistering diseases (n=144). For group 1, positive DIF findings demonstrated: predominance of IgG intercellular staining (ICS) and C3 for pemphigus foliaceus-PF (94% and 73% respectively), pemphigus vulgaris-PV (91.5%-79.5%) and paraneoplastic pemphigus-PNP (66%-33%); ICS IgA in 100% of IgA pemphigus cases, and IgG deposits in the basement membrane zone (BMZ) along with ICS in one Hailey-Hailey patient. The IIF findings revealed mean titers of 1:2.560 for PV and 1:1.280 for PF. For paraneoplastic pemphigus, IIF was positive in 2 out of 3 cases with rat bladder substrate. In group 2, positive DIF findings included multiple deposits at basement membrane zone for epidermolysis bullosa acquisita-EBA (C3-89%,IgG-79%,IgA-47%,IgM-21%) mucous membrane pemphigoid-MMP (C3,IgG,IgA,IgM-80%) and bullous pemphigoid-BP (C3-91%,IgG-39%,IgA-11%,IgM-6%), and IgA at basement membrane zone for IgA linear disease (99%) and dermatitis herpetiformis-DH (dermal papillae in 84.6%). For lichen planus pemphigoides, there was C3 (100%) and IgG (50%) deposition at basement membrane zone. indirect immunofluorescence positive findings revealed basement membrane zone IgG deposits in 46% of BP patients, 50% for EBA, 15% for IgA linear dermatosis and 50% for LPP. Indirect immunofluorescence positive results were higher for BP and EBA with Salt-Split skin substrate.

Conclusion: Our results confirmed the importance of immunofluorescence assays in diagnosing autoimmune blistering diseases, and higher sensitivity for indirect immunofluorescence when Salt-split skin technique is performed.

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Related in: MedlinePlus

Salt-split skin. Epidermolysis bullosa acquisita. IgG on dermal side
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f03: Salt-split skin. Epidermolysis bullosa acquisita. IgG on dermal side

Mentions: EBA: IgG in 50% (9/18) at BMZ. SS: dermal side: IgG in 38.5% (5/13), IgA and IgGin 23% (3/13) (Figure 3).


Immunofluorescence testing in the diagnosis of autoimmune blistering diseases: overview of 10-year experience.

Arbache ST, Nogueira TG, Delgado L, Miyamoto D, Aoki V - An Bras Dermatol (2014 Nov-Dec)

Salt-split skin. Epidermolysis bullosa acquisita. IgG on dermal side
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4230656&req=5

f03: Salt-split skin. Epidermolysis bullosa acquisita. IgG on dermal side
Mentions: EBA: IgG in 50% (9/18) at BMZ. SS: dermal side: IgG in 38.5% (5/13), IgA and IgGin 23% (3/13) (Figure 3).

Bottom Line: In group 2, positive DIF findings included multiple deposits at basement membrane zone for epidermolysis bullosa acquisita-EBA (C3-89%,IgG-79%,IgA-47%,IgM-21%) mucous membrane pemphigoid-MMP (C3,IgG,IgA,IgM-80%) and bullous pemphigoid-BP (C3-91%,IgG-39%,IgA-11%,IgM-6%), and IgA at basement membrane zone for IgA linear disease (99%) and dermatitis herpetiformis-DH (dermal papillae in 84.6%).For lichen planus pemphigoides, there was C3 (100%) and IgG (50%) deposition at basement membrane zone. indirect immunofluorescence positive findings revealed basement membrane zone IgG deposits in 46% of BP patients, 50% for EBA, 15% for IgA linear dermatosis and 50% for LPP.Indirect immunofluorescence positive results were higher for BP and EBA with Salt-Split skin substrate.

View Article: PubMed Central - PubMed

Affiliation: Universidade de São Paulo, São Paulo, SP, Brazil.

ABSTRACT

Background: Immunofluorescence testing is an important tool for diagnosing blistering diseases.

Objective: To characterize the immunofluorescence findings in patients diagnosed with autoimmune blistering skin diseases.

Methods: We retrospectively analyzed immunofluorescence results encompassing a 10-year period.

Results: 421 patients were included and divided into 2 groups: group 1- intraepidermal blistering diseases (n=277) and 2- subepidermal blistering diseases (n=144). For group 1, positive DIF findings demonstrated: predominance of IgG intercellular staining (ICS) and C3 for pemphigus foliaceus-PF (94% and 73% respectively), pemphigus vulgaris-PV (91.5%-79.5%) and paraneoplastic pemphigus-PNP (66%-33%); ICS IgA in 100% of IgA pemphigus cases, and IgG deposits in the basement membrane zone (BMZ) along with ICS in one Hailey-Hailey patient. The IIF findings revealed mean titers of 1:2.560 for PV and 1:1.280 for PF. For paraneoplastic pemphigus, IIF was positive in 2 out of 3 cases with rat bladder substrate. In group 2, positive DIF findings included multiple deposits at basement membrane zone for epidermolysis bullosa acquisita-EBA (C3-89%,IgG-79%,IgA-47%,IgM-21%) mucous membrane pemphigoid-MMP (C3,IgG,IgA,IgM-80%) and bullous pemphigoid-BP (C3-91%,IgG-39%,IgA-11%,IgM-6%), and IgA at basement membrane zone for IgA linear disease (99%) and dermatitis herpetiformis-DH (dermal papillae in 84.6%). For lichen planus pemphigoides, there was C3 (100%) and IgG (50%) deposition at basement membrane zone. indirect immunofluorescence positive findings revealed basement membrane zone IgG deposits in 46% of BP patients, 50% for EBA, 15% for IgA linear dermatosis and 50% for LPP. Indirect immunofluorescence positive results were higher for BP and EBA with Salt-Split skin substrate.

Conclusion: Our results confirmed the importance of immunofluorescence assays in diagnosing autoimmune blistering diseases, and higher sensitivity for indirect immunofluorescence when Salt-split skin technique is performed.

Show MeSH
Related in: MedlinePlus