J Jankásková1,2, O N Horváth1, R Varga1, P Arenberger2, E Schmidt3,4, T Ruzicka1, M Sárdy1. 1. Department of Dermatology and Allergology, Ludwig Maximilian University, Munich, Germany. 2. Department of Dermato-Venerology, Teaching Hospital Královské Vinohrady, Third Faculty of Medicine, Charles University in Prague, Prague, Czech Republic. 3. Department of Dermatology, Allergology and Venerology, University of Lübeck, Lübeck, Germany. 4. Lübeck Institute of Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany.
Abstract
BACKGROUND: Indirect immunofluorescence (IIF) microscopy on monkey oesophagus is an important assay for the diagnosis of bullous pemphigoid (BP). Its relatively low sensitivity (60-80%) may be partly due to insufficient detection of minor IgG subclasses. AIM: To determine the operating characteristics of an IgG subclass in IIF. METHODS: We designed a retrospective, dual-centre, controlled cohort study on sera from 64 BP sera that had been rated as false negatives by traditional IIF microscopy, and assessed circulating IgG1 , IgG3 and IgG4 autoantibodies. RESULTS: The sensitivities of IIF in detecting IgG1 , IgG3 , IgG4 and all three in combination were 45.3%, 18.8%, 32.8% and 48.4%, respectively. Specificities were > 97%. CONCLUSION: Detection of IgG subclass (especially IgG1 and IgG4 ) autoantibodies by IIF on monkey oesophagus can significantly improve diagnostic performance of IIF microscopy for diagnosis of BP.
BACKGROUND: Indirect immunofluorescence (IIF) microscopy on monkey oesophagus is an important assay for the diagnosis of bullous pemphigoid (BP). Its relatively low sensitivity (60-80%) may be partly due to insufficient detection of minor IgG subclasses. AIM: To determine the operating characteristics of an IgG subclass in IIF. METHODS: We designed a retrospective, dual-centre, controlled cohort study on sera from 64 BP sera that had been rated as false negatives by traditional IIF microscopy, and assessed circulating IgG1 , IgG3 and IgG4 autoantibodies. RESULTS: The sensitivities of IIF in detecting IgG1 , IgG3 , IgG4 and all three in combination were 45.3%, 18.8%, 32.8% and 48.4%, respectively. Specificities were > 97%. CONCLUSION: Detection of IgG subclass (especially IgG1 and IgG4 ) autoantibodies by IIF on monkey oesophagus can significantly improve diagnostic performance of IIF microscopy for diagnosis of BP.
Authors: Joost M Meijer; Gilles F H Diercks; Emma W G de Lang; Hendri H Pas; Marcel F Jonkman Journal: JAMA Dermatol Date: 2019-02-01 Impact factor: 10.282
Authors: S Emtenani; H Yuan; C Lin; M Pan; J E Hundt; E Schmidt; L Komorowski; J R Stanley; C M Hammers Journal: Br J Dermatol Date: 2019-01-01 Impact factor: 9.302