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

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

Research output: Contribution to journal › Article › peer-review

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.

Original language	English
Pages (from-to)	1268-74
Number of pages	7
Journal	Journal der Deutschen Dermatologischen Gesellschaft
Volume	13
Issue number	12
DOIs	https://doi.org/10.1111/ddg.12716
Publication status	Published - Dec 2015
Externally published	Yes

Fields of science

302 Clinical Medicine

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10.1111/ddg.12716

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@article{06d34daf421c4062b188ed264039f0a3,

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",

volume = "13",

pages = "1268--74",

journal = "Journal der Deutschen Dermatologischen Gesellschaft",

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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.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Biomarkers/analysis

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

UR - https://www.scopus.com/pages/publications/84948439331

U2 - 10.1111/ddg.12716

DO - 10.1111/ddg.12716

M3 - Article

C2 - 26612798

SN - 1610-0387

VL - 13

SP - 1268

EP - 1274

JO - Journal der Deutschen Dermatologischen Gesellschaft

JF - Journal der Deutschen Dermatologischen Gesellschaft

IS - 12

ER -

Diagnostic relevance of direct immunofluorescence in ocular mucous membrane pemphigoid

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