Comparative study of direct and indirect immunofluorescence and of bullous pemphigoid 180 and 230 enzyme-linked immunosorbent assays for diagnosis of bullous pemphigoid

Direct immunofluorescence (DIF), indirect immunofluorescence (IIF), and enzyme-linked immunosorbent assay (ELISA) are used for the laboratory diagnosis of bullous pemphigoid (BP). The diagnostic value of DIF and IIF on rabbit and monkey esophagus or human salt-split skin and commercial ELISAs was as...

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Veröffentlicht in:Journal of the American Academy of Dermatology Jg. 69; H. 5; S. 748 - 753
Hauptverfasser: Sárdy, Miklós, Kostaki, Dimitra, Varga, Rita, Peris, Ketty, Ruzicka, Thomas
Format: Journal Article
Sprache:Englisch
Veröffentlicht: United States Elsevier Inc 01.11.2013
Schlagworte:
Adolescent
Adult
Aged
Aged, 80 and over
Autoantigens - analysis
bullous pemphigoid
bullous pemphigoid 180
bullous pemphigoid 230
Carrier Proteins - analysis
Child
Collagen Type XVII
collagen XVII
Cytoskeletal Proteins - analysis
Dermatology
diagnostics
Dystonin
Enzyme-Linked Immunosorbent Assay
esophagus
Female
Fluorescent Antibody Technique, Direct
Fluorescent Antibody Technique, Indirect
Humans
immunofluorescence
Male
Middle Aged
Nerve Tissue Proteins - analysis
Non-Fibrillar Collagens - analysis
Pemphigoid, Bullous - diagnosis
Retrospective Studies
sensitivity
Sensitivity and Specificity
specificity
Young Adult
DIF
bullous pemphigoid 230
collagen XVII
CI
IIF
BMZ
BP
bullous pemphigoid
diagnostics
specificity
sensitivity
esophagus
bullous pemphigoid 180
immunofluorescence
ELISA
indirect immunofluorescence
direct immunofluorescence
enzyme-linked immunosorbent assay
basement membrane zone
confidence interval
ISSN:0190-9622, 1097-6787, 1097-6787
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Zusammenfassung:Direct immunofluorescence (DIF), indirect immunofluorescence (IIF), and enzyme-linked immunosorbent assay (ELISA) are used for the laboratory diagnosis of bullous pemphigoid (BP). The diagnostic value of DIF and IIF on rabbit and monkey esophagus or human salt-split skin and commercial ELISAs was assessed. This was a single-center retrospective study where 313 patients with BP were compared with 488 control subjects. DIF was the most sensitive test (90.8%) whereas sensitivities for IIF on rabbit esophagus, IIF on monkey esophagus, IIF on salt-split skin, BP180 ELISA, and BP230 ELISA were 76.0%, 73.2%, 73.3%, 72.0%, and 59.0%, respectively. The sensitivity of the serologic tests was 88.8% altogether. The specificities for DIF, IIF on rabbit esophagus, IIF on monkey esophagus, IIF on salt-split skin, BP180 ELISA, and BP230 ELISA were 98%, 96.5%, 97.1%, 100%, 94.1%, and 99.2%, respectively. The retrospective nature of study was a limitation. Correlation of diagnostic data with clinical manifestations or disease course was not possible. In suspected BP, both serologic tests and DIF have to be performed because of a sensitivity issue. Although the ELISAs had a relatively low sensitivity, the serologic tests altogether almost reached the level of sensitivity of DIF. The specificities of all assays were excellent.
Bibliographie:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
content type line 23
ISSN:0190-9622
1097-6787
1097-6787
DOI:10.1016/j.jaad.2013.07.009