Circulating bullous pemphigoid autoantibodies in the setting of negative direct immunofluorescence findings for bullous pemphigoid: A single-center retrospective review - 20/06/19
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Abstract |
Background |
Bullous pemphigoid (BP) autoantibody levels are generally elevated in patients with BP but can be present nonspecifically in patients without BP.
Objective |
To analyze the clinical findings of patients with elevated BP180 or BP230 autoantibody levels and negative direct immunofluorescence (DIF) study findings.
Methods |
We retrospectively reviewed records of patients seen at our institution during January 1, 2005-December 31, 2015, who were positive for BP180 or BP230 autoantibodies and had a negative DIF study finding. These patients' demographic characteristics and BP180 and BP230 levels were compared with those of a BP control group who were positive for BP180 or BP230 autoantibodies and had positive DIF study findings.
Results |
We identified 208 patients with BP autoantibodies but without positive DIF study findings. These patients' mean age and enzyme-linked immunosorbent assay values were significantly lower than those of the control group. Dermatitis was the most common final clinical diagnosis. Of the 208 patients, 41 (19.7%) had at least 2 years' follow-up. Four patients had positive DIF results upon repeating the test and ultimately received pemphigoid diagnoses.
Limitations |
Retrospective design with limited follow-up.
Conclusion |
Patients might harbor serum BP autoantibodies in the context of a wide range of dermatoses. Low positive BP180 and BP230 autoantibody levels should not be overinterpreted as evidence for BP in the setting of a negative DIF.
Le texte complet de cet article est disponible en PDF.Key words : autoantibody, basement membrane zone, bullous diseases, immunobullous, immunofluorescence, medical dermatology, pemphigoid
Abbreviations used : ANA, BMZ, BP, DIF, ELISA, ICD-10, IIF, IQR, MMP, NPV, PPV
Plan
Funding sources: None. |
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Conflicts of interest: None disclosed. |
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