Comparative study of direct and indirect immunofluorescence and of bullous pemphigoid 180 and 230 enzyme-linked immunosorbent assays for diagnosis of bullous pemphigoid - 23/10/13
, Dimitra Kostaki, MD a, b, Rita Varga, MD a, Ketty Peris, MD, PhD b, Thomas Ruzicka, MD aAbstract |
Background |
Direct immunofluorescence (DIF), indirect immunofluorescence (IIF), and enzyme-linked immunosorbent assay (ELISA) are used for the laboratory diagnosis of bullous pemphigoid (BP).
Objective |
The diagnostic value of DIF and IIF on rabbit and monkey esophagus or human salt-split skin and commercial ELISAs was assessed.
Methods |
This was a single-center retrospective study where 313 patients with BP were compared with 488 control subjects.
Results |
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.
Limitations |
The retrospective nature of study was a limitation. Correlation of diagnostic data with clinical manifestations or disease course was not possible.
Conclusions |
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.
Le texte complet de cet article est disponible en PDF.Key words : bullous pemphigoid, bullous pemphigoid 180, bullous pemphigoid 230, collagen XVII, diagnostics, esophagus, immunofluorescence, sensitivity, specificity
Abbreviations used : BMZ, BP, CI, DIF, ELISA, IIF
Plan
| Funding sources: None. |
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| Conflicts of interest: None declared. |
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| Reprints not available from the authors. |
Vol 69 - N° 5
P. 748-753 - novembre 2013 Retour au numéro
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