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Immunofluorescence testing in the diagnosis of autoimmune blistering diseases: overview of 10-year experience
Arbache, Samia Trigo; Nogueira, Tarsila Gasparotto; Delgado, Lívia; Miyamoto, Denise; Aoki, Valéria.
  • Arbache, Samia Trigo; Universidade de São Paulo. São Paulo. BR
  • Nogueira, Tarsila Gasparotto; Universidade de São Paulo. São Paulo. BR
  • Delgado, Lívia; Universidade de São Paulo. São Paulo. BR
  • Miyamoto, Denise; Universidade de São Paulo. São Paulo. BR
  • Aoki, Valéria; Universidade de São Paulo. São Paulo. BR
An. bras. dermatol ; 89(6): 885-889, Nov-Dec/2014. tab, graf
Article in English | LILACS | ID: lil-727652
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 12.560 for PV and 11.280 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 ...
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Full text: Available Index: LILACS (Americas) Main subject: Autoimmune Diseases / Fluorescent Antibody Technique / Skin Diseases, Vesiculobullous Type of study: Diagnostic study / Observational study Limits: Female / Humans / Male Language: English Journal: An. bras. dermatol Journal subject: Dermatology Year: 2014 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade de São Paulo/BR

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Full text: Available Index: LILACS (Americas) Main subject: Autoimmune Diseases / Fluorescent Antibody Technique / Skin Diseases, Vesiculobullous Type of study: Diagnostic study / Observational study Limits: Female / Humans / Male Language: English Journal: An. bras. dermatol Journal subject: Dermatology Year: 2014 Type: Article Affiliation country: Brazil Institution/Affiliation country: Universidade de São Paulo/BR