Ana Maria Abreu-Velez1, Yulieth A Upegui-Zapata2, Carlos A Valencia-Yepes3, Eduardo Upegui-Quiceno4, Alejandra M Jiménez-Echavarría4, César D Niño-Pulido5, Bruce R Smoller6, Michael S Howard1. 1. Georgia Dermatopathology Associates, Atlanta, GA, USA. 2. PECET Group, Pharmaceutical Sciences, Medical Research Institute, School of Medicine, University of Antioquia, Medellín, Colombia. 3. Department of Education, University of Antioquia, Medellín, Colombia. 4. PECET Group, University of Antioquia, Medellín, Colombia. 5. CES University, Medellín, Colombia. 6. Departments of Pathology and Laboratory Medicine & Dermatology, University of Rochester Medical Center, School of Medicine and Dentistry, Rochester, NY, USA.
Abstract
BACKGROUND: A new variant of endemic pemphigus foliaceus in El Bagre (El Bagre-EPF), Colombia, South America, shares features with Senear-Usher syndrome and occurs in an endemic fashion. Patients affected by El Bagre-EPF have heterogeneous antigenic reactivity not only to the skin but to other organs, including the heart. Here we test for autoantibodies to the areae compositae of the heart (structure consisting of typical desmosomal amalgamated fascia adherens molecules) and evaluate any possible clinical correlation. METHODS: A case-control study comparing 45 patients and 45 controls from the endemic area, matched by demographics including age, gender, weight, work activities, and comorbidities, was performed. Direct and indirect immunofluorescence, immunohistochemistry, confocal microscopic studies, and echocardiogram studies were completed. RESULTS: The main clinical abnormally seen in the El Bagre-EPF patients was left ventricular hypertrophy in 15/45 patients, compared with no such findings in the control population (P < 0.1). Seventy percent of El Bagre-EPF patients and none of the controls displayed polyclonal autoreactivity using different immunoglobulins and complement to the areae compositae of the heart using different methods and antibodies (P < 0.1). CONCLUSIONS: Patients affected by El Bagre-EPF demonstrated autoantibodies to the areae compositae of the heart. This finding was associated with left ventricular hypertrophic cardiomyopathy. The areae compositae may play a role in cell junction tension and the El Bagre-EPF patients' autoantibodies possibly disrupting these junctions and thereby contributing to the left ventricular hypertrophy.
BACKGROUND: A new variant of endemic pemphigus foliaceus in El Bagre (El Bagre-EPF), Colombia, South America, shares features with Senear-Usher syndrome and occurs in an endemic fashion. Patients affected by El Bagre-EPF have heterogeneous antigenic reactivity not only to the skin but to other organs, including the heart. Here we test for autoantibodies to the areae compositae of the heart (structure consisting of typical desmosomal amalgamated fascia adherens molecules) and evaluate any possible clinical correlation. METHODS: A case-control study comparing 45 patients and 45 controls from the endemic area, matched by demographics including age, gender, weight, work activities, and comorbidities, was performed. Direct and indirect immunofluorescence, immunohistochemistry, confocal microscopic studies, and echocardiogram studies were completed. RESULTS: The main clinical abnormally seen in the El Bagre-EPF patients was left ventricular hypertrophy in 15/45 patients, compared with no such findings in the control population (P < 0.1). Seventy percent of El Bagre-EPF patients and none of the controls displayed polyclonal autoreactivity using different immunoglobulins and complement to the areae compositae of the heart using different methods and antibodies (P < 0.1). CONCLUSIONS: Patients affected by El Bagre-EPF demonstrated autoantibodies to the areae compositae of the heart. This finding was associated with left ventricular hypertrophic cardiomyopathy. The areae compositae may play a role in cell junction tension and the El Bagre-EPF patients' autoantibodies possibly disrupting these junctions and thereby contributing to the left ventricular hypertrophy.
Entities:
Keywords:
ARVCF; MYZAP; areae compositae of the heart; desmoplakins I and II; endemic pemphigus foliaceus; left cardiac hypertrophy; p0071
Authors: Ana María Abrèu-Velez; Takashi Hashimoto; Wendy B Bollag; Sergio Tobón Arroyave; Clara Eugenia Abrèu-Velez; Martha Luz Londoño; Fernando Montoya; Ernst H Beutner Journal: J Am Acad Dermatol Date: 2003-10 Impact factor: 11.527
Authors: Ana María Abrèu-Velez; Ernst H Beutner; Fernando Montoya; Wendy B Bollag; Takashi Hashimoto Journal: J Am Acad Dermatol Date: 2003-10 Impact factor: 11.527
Authors: Ana María Abréu-Vélez; Maria Mercedes Yepes; Pablo Javier Patiño; Wendy B Bollag; Fernando Montoya Journal: Arch Dermatol Res Date: 2004-01-17 Impact factor: 3.017