BACKGROUND: Paraneoplastic pemphigus is a blistering disease with specific serum immunoprecipitation findings. Although immunoprecipitation studies allow accurate diagnosis, they are time-consuming, expensive, and not readily available. In contrast, indirect immunofluorescence (IIF) testing of serum on transitional rat bladder epithelium is a simple and inexpensive method available to any immunopathology laboratory. OBJECTIVE: Our purpose was to determine the specificity of positive IIF on rat bladder epithelium for paraneoplastic pemphigus. METHODS: The IIF findings in four index cases of paraneoplastic pemphigus were compared with the findings in 47 patients with a variety of malignant neoplasms and no associated blistering disease as well as 49 patients with vesiculobullous or lichenoid disease but no neoplasia. RESULTS: IIF was negative in all patients with neoplasia and no blistering disease and negative in all but one of the patients with vesiculobullous or lichenoid disease without neoplasia (98.9% specificity). CONCLUSION: IIF on transitional rat bladder epithelium appears to be a highly specific test for paraneoplastic pemphigus. Because of its simplicity and inexpensiveness, we suggest that IIF be performed on transitional epithelium in any suspected case of paraneoplastic pemphigus.
BACKGROUND:Paraneoplastic pemphigus is a blistering disease with specific serum immunoprecipitation findings. Although immunoprecipitation studies allow accurate diagnosis, they are time-consuming, expensive, and not readily available. In contrast, indirect immunofluorescence (IIF) testing of serum on transitional rat bladder epithelium is a simple and inexpensive method available to any immunopathology laboratory. OBJECTIVE: Our purpose was to determine the specificity of positive IIF on rat bladder epithelium for paraneoplastic pemphigus. METHODS: The IIF findings in four index cases of paraneoplastic pemphigus were compared with the findings in 47 patients with a variety of malignant neoplasms and no associated blistering disease as well as 49 patients with vesiculobullous or lichenoid disease but no neoplasia. RESULTS: IIF was negative in all patients with neoplasia and no blistering disease and negative in all but one of the patients with vesiculobullous or lichenoid disease without neoplasia (98.9% specificity). CONCLUSION: IIF on transitional rat bladder epithelium appears to be a highly specific test for paraneoplastic pemphigus. Because of its simplicity and inexpensiveness, we suggest that IIF be performed on transitional epithelium in any suspected case of paraneoplastic pemphigus.
Authors: Damaris G Ortolan; Danielle P G Souza; Valéria Aoki; Claudia G Santi; Tatiana V B Gabbi; Ligia M F Ichimura; Celina W Maruta Journal: Clinics (Sao Paulo) Date: 2011 Impact factor: 2.365
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Authors: E Schmidt; H Rashid; A V Marzano; A Lamberts; G Di Zenzo; G F H Diercks; S Alberti-Violetti; R J Barry; L Borradori; M Caproni; B Carey; M Carrozzo; G Cianchini; A Corrà; F G Dikkers; C Feliciani; G Geerling; G Genovese; M Hertl; P Joly; J M Meijer; V Mercadante; D F Murrell; M Ormond; H H Pas; A Patsatsi; S Rauz; B D van Rhijn; M Roth; J Setterfield; D Zillikens; G Zambruno; B Horváth; F Caux Journal: J Eur Acad Dermatol Venereol Date: 2021-07-26 Impact factor: 6.166