Poot, A. M.; Diercks, G. F. H.; Kramer, D.; Schepens, Isabelle; Klunder, G.; Hashimoto, T.; Borradori, Luca; Jonkman, M. F.; Pas, H. H. (2013). Laboratory diagnosis of paraneoplastic pemphigus. British journal of dermatology, 169(5), pp. 1016-1024. Wiley-Blackwell 10.1111/bjd.12479
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BACKGROUND
Paraneoplastic pemphigus (PNP) is a multiorgan disease characterized by antibodies against plakins, desmogleins and the α2-macroglobulin-like-1 (A2ML1) protein, in association with an underlying neoplasm. Accurate diagnosis relies on the demonstration of these autoantibodies in serum.
OBJECTIVES
To evaluate the value of different laboratory techniques in the serological diagnosis of PNP.
METHODS
We performed immunoblotting, envoplakin (EP) enzyme-linked immunosorbent assay (ELISA), indirect immunofluorescence (IIF) on rat bladder, radioactive immunoprecipitation and a nonradioactive combined immunoprecipitation-immunoblot assay. Additional assays included BP180 ELISA and BP230 ELISA. We included the sera of 19 patients with PNP and 40 control subjects.
RESULTS
The sensitivities were 63% for anti-EP ELISA, 74% for rat bladder IIF, 89% for immunoblotting, 95% for radioactive immunoprecipitation and 100% for nonradioactive immunoprecipitation. Specificities ranged from 86% to 100%. The BP180 and BP230 ELISAs had low sensitivity and specificity for PNP. The combination of rat bladder IIF and immunoblot showed 100% sensitivity and specificity. The analysis of sequential PNP sera showed that antibody titres may decrease over time, possibly resulting in negative outcomes for EP ELISA and rat bladder IIF studies.
CONCLUSIONS
The detection of autoantibodies against EP and periplakin, or A2ML1 by immunoprecipitation is most sensitive for PNP. The combination of rat bladder IIF and immunoblotting is equally sensitive and highly specific, and represents an alternative valuable and relatively easy approach for the serological diagnosis of PNP.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Dermatology 04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Radio-Onkologie 04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > DBMR Forschung Mu35 > Forschungsgruppe Radio-Onkologie |
UniBE Contributor: |
Schepens, Isabelle, Borradori, Luca |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
0007-0963 |
Publisher: |
Wiley-Blackwell |
Language: |
English |
Submitter: |
Monika Schenk |
Date Deposited: |
16 Jun 2014 08:02 |
Last Modified: |
05 Dec 2022 14:30 |
Publisher DOI: |
10.1111/bjd.12479 |
PubMed ID: |
23796242 |
BORIS DOI: |
10.7892/boris.45607 |
URI: |
https://boris.unibe.ch/id/eprint/45607 |
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