ABSTRACT
Anti-desmoglein (anti-Dsg) ELISA and indirect immunofluorescence (IIF) are used for the diagnosis of pemphigus vulgaris (PV). The value of salivary ELISA, serum ELISA, and IIF in the diagnosis of PV, and the correlation of salivary anti-Dsg1 and anti-Dsg3 ELISA with serum ELISA, serum and salivary IIF titers, and disease severity in patients with PV were evaluated. Fifty newly diagnosed patients with PV were enrolled in the study. Demographic data and disease-severity scores were recorded for each patient. Anti-Dsg1 and anti-Dsg3 ELISA and IIF were performed on both serum and salivary samples. Given the cut-off value of 20 RU/mL for Dsg1 and Dsg3, serum Dsg1 and Dsg3 ELISA were positive in 41 (82%) and 40 (80%) patients, and saliva Dsg1 and the Dsg3 ELISA were positive in 2 (4%) and 3 (6%) patients, respectively. Using the cut-off value of 13.4 RU/mL and 7.7 RU/mL for Dsg3 and Dsg1 salivary ELISA, 25 (50%) and 23 (46%) patients tested positive for Dsg3 and Dsg1, respectively. Serum IIF results were positive in 35 (70%) patients, and salivary IIF results were positive in 16 (32%) patients. Salivary anti-Dsg1 and anti-Dsg3 showed moderate correlations with the total pemphigus disease area index (PDAI) score (r=0.466, P<0.001), (r=0.459, P<0.001), respectively. A moderate correlation between serum IIF and salivary IIF was also detected (r=0.413, P<0.001). Salivary anti-Dsg1 and anti-Dsg3 ELISA could be used as a safe and noninvasive method for the diagnosis of PV under certain circumstances, especially in children or elderly patients. Salivary ELISA is superior to salivary IIF.
Subject(s)
Autoantibodies/metabolism , Desmoglein 1/immunology , Desmoglein 3/immunology , Pemphigus/diagnosis , Pemphigus/metabolism , Saliva/immunology , Adult , Aged , Cross-Sectional Studies , Enzyme-Linked Immunosorbent Assay , Female , Fluorescent Antibody Technique, Indirect , Humans , Male , Middle Aged , Pemphigus/immunology , Predictive Value of Tests , Severity of Illness Index , Young AdultSubject(s)
Desmoglein 1/drug effects , Desmoglein 3/drug effects , Edetic Acid/administration & dosage , Pemphigus/diagnosis , Pemphigus/drug therapy , Adult , Biomarkers/metabolism , Case-Control Studies , Desmoglein 1/metabolism , Desmoglein 3/metabolism , Female , Follow-Up Studies , Humans , Kaplan-Meier Estimate , Male , Middle Aged , Recurrence , Remission, Spontaneous , Severity of Illness Index , Treatment OutcomeABSTRACT
OBJECTIVE: To determine the value of random urinary protein to creatinine ratio (UPCR) for diagnosis of proteinuria in pregnant women with preeclampsia. Preeclampsia is the most common complication of pregnancy and one of the main causes of maternal mortality. So, early diagnosis of preeclampsia is very important. MATERIALS AND METHODS: In this cross-sectional study 66 pregnant women suspected preeclampsia at ≥24 week of gestational age and BP ≥ 140/90 mm/Hg were checked by two urine samples of 10am and 4pm to determine random UPCR, as well as a 24-hour urine sample to evaluate 24-hour protein excretion. RESULTS: The result revealed that 74.2% of the studied population had significant proteinuria. There was a correlation between UPCR and 24-hour urine protein excretion. Pearson's correlation coefficient was 0.502 at 10am and 0.428 at 4pm. The best cutoff for the random urine protein to creatinine ratio at 10am was 0.470 with sensitivity and specificity equal to 87.5% and 84.2%, respectively. The best cutoff for the random UPCR at 4pm was 0.595 with sensitivity and specificity equal to 91.7% and 94.7%, respectively. CONCLUSION: Result of 24-hour urine collection showing random UPCR is considered as an appropriate situated method for emergency time.
