Diagnostic relevance of direct immunofluorescence in ocular mucous membrane pemphigoid

Tarun Mehra; Emmanuella Guenova; Frieder Dechent; Florian Würth; Manfred Zierhut; Martin Röcken; Martin Schaller; Christoph Deuter

doi:10.1111/ddg.12716

Diagnostic relevance of direct immunofluorescence in ocular mucous membrane pemphigoid

Titel in Übersetzung: Die diagnostische Relevanz der direkten Immunfluoreszenz beim okulären Schleimhautpemphigoid

Tarun Mehra
, Emmanuella Guenova
, Frieder Dechent
, Florian Würth
, Manfred Zierhut
, Martin Röcken
, Martin Schaller
, Christoph Deuter

Publikation: Beitrag in Fachzeitschrift › Artikel › Begutachtung

Abstract

BACKGROUND AND OBJECTIVES: The objective was to determine the diagnostic value of direct immunofluorescence (DIF) in ocular mucous membrane pemphigoid (ocular MMP), taking into account immunofluorescence patterns and biopsy sites.

PATIENTS AND METHODS: DIF results and medical records of 54 patients with a suspected diagnosis of ocular MMP were reviewed.

RESULTS: There was an overall prevalence of ocular MMP in 70.4 % of cases. Linear deposition of IgA, IgG, or C3 showed a high positive predictive value (84-100 %). Sensitivity and negative predictive value of IgG, IgM, IgG, and C3 in DIF were higher in cutaneous samples than in conjunctival biopsies, thus yielding a higher diagnostic accuracy. The sensitivity of DIF in ocular MMP seems to be lower than in bullous pemphigoid.

CONCLUSIONS: The diagnostic value of DIF in the workup of ocular MMP was confirmed. However, biopsies taken from non-conjunctival, cutaneous tissue appear to yield more accurate results.

Titel in Übersetzung	Die diagnostische Relevanz der direkten Immunfluoreszenz beim okulären Schleimhautpemphigoid
Originalsprache	Englisch
Seiten (von - bis)	1268-1274
Seitenumfang	7
Fachzeitschrift	Journal der Deutschen Dermatologischen Gesellschaft
Volume	13
Ausgabenummer	12
DOIs	https://doi.org/10.1111/ddg.12716
Publikationsstatus	Veröffentlicht - Dez. 2015
Extern publiziert	Ja

Wissenschaftszweige

302 Klinische Medizin

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10.1111/ddg.12716

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title = "Diagnostic relevance of direct immunofluorescence in ocular mucous membrane pemphigoid",

abstract = "BACKGROUND AND OBJECTIVES: The objective was to determine the diagnostic value of direct immunofluorescence (DIF) in ocular mucous membrane pemphigoid (ocular MMP), taking into account immunofluorescence patterns and biopsy sites.PATIENTS AND METHODS: DIF results and medical records of 54 patients with a suspected diagnosis of ocular MMP were reviewed.RESULTS: There was an overall prevalence of ocular MMP in 70.4 \% of cases. Linear deposition of IgA, IgG, or C3 showed a high positive predictive value (84-100 \%). Sensitivity and negative predictive value of IgG, IgM, IgG, and C3 in DIF were higher in cutaneous samples than in conjunctival biopsies, thus yielding a higher diagnostic accuracy. The sensitivity of DIF in ocular MMP seems to be lower than in bullous pemphigoid.CONCLUSIONS: The diagnostic value of DIF in the workup of ocular MMP was confirmed. However, biopsies taken from non-conjunctival, cutaneous tissue appear to yield more accurate results.",

keywords = "Adult, Aged, Aged, 80 and over, Biomarkers/analysis, Cytokines/immunology, Female, Fluorescent Antibody Technique, Direct/methods, Humans, Male, Middle Aged, Pemphigoid, Benign Mucous Membrane/diagnosis, Reproducibility of Results, Sensitivity and Specificity",

author = "Tarun Mehra and Emmanuella Guenova and Frieder Dechent and Florian W{\"u}rth and Manfred Zierhut and Martin R{\"o}cken and Martin Schaller and Christoph Deuter",

note = "{\textcopyright} 2015 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley \& Sons Ltd.",

year = "2015",

month = dec,

doi = "10.1111/ddg.12716",

language = "English",

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T1 - Diagnostic relevance of direct immunofluorescence in ocular mucous membrane pemphigoid

AU - Mehra, Tarun

AU - Guenova, Emmanuella

AU - Dechent, Frieder

AU - Würth, Florian

AU - Zierhut, Manfred

AU - Röcken, Martin

AU - Schaller, Martin

AU - Deuter, Christoph

PY - 2015/12

Y1 - 2015/12

N2 - BACKGROUND AND OBJECTIVES: The objective was to determine the diagnostic value of direct immunofluorescence (DIF) in ocular mucous membrane pemphigoid (ocular MMP), taking into account immunofluorescence patterns and biopsy sites.PATIENTS AND METHODS: DIF results and medical records of 54 patients with a suspected diagnosis of ocular MMP were reviewed.RESULTS: There was an overall prevalence of ocular MMP in 70.4 % of cases. Linear deposition of IgA, IgG, or C3 showed a high positive predictive value (84-100 %). Sensitivity and negative predictive value of IgG, IgM, IgG, and C3 in DIF were higher in cutaneous samples than in conjunctival biopsies, thus yielding a higher diagnostic accuracy. The sensitivity of DIF in ocular MMP seems to be lower than in bullous pemphigoid.CONCLUSIONS: The diagnostic value of DIF in the workup of ocular MMP was confirmed. However, biopsies taken from non-conjunctival, cutaneous tissue appear to yield more accurate results.

AB - BACKGROUND AND OBJECTIVES: The objective was to determine the diagnostic value of direct immunofluorescence (DIF) in ocular mucous membrane pemphigoid (ocular MMP), taking into account immunofluorescence patterns and biopsy sites.PATIENTS AND METHODS: DIF results and medical records of 54 patients with a suspected diagnosis of ocular MMP were reviewed.RESULTS: There was an overall prevalence of ocular MMP in 70.4 % of cases. Linear deposition of IgA, IgG, or C3 showed a high positive predictive value (84-100 %). Sensitivity and negative predictive value of IgG, IgM, IgG, and C3 in DIF were higher in cutaneous samples than in conjunctival biopsies, thus yielding a higher diagnostic accuracy. The sensitivity of DIF in ocular MMP seems to be lower than in bullous pemphigoid.CONCLUSIONS: The diagnostic value of DIF in the workup of ocular MMP was confirmed. However, biopsies taken from non-conjunctival, cutaneous tissue appear to yield more accurate results.

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KW - Aged, 80 and over

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KW - Cytokines/immunology

KW - Female

KW - Fluorescent Antibody Technique, Direct/methods

KW - Humans

KW - Male

KW - Middle Aged

KW - Pemphigoid, Benign Mucous Membrane/diagnosis

KW - Reproducibility of Results

KW - Sensitivity and Specificity

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