Comparison of desmoglein 1 and 3 enzyme-linked immunosorbent assay and direct immunofluorescence for evaluation of immunological remission in pemphigus vulgaris.

Abstract

BACKGROUND:

Drug withdrawal is the ultimate goal in the management of patients with pemphigus. Direct immunofluorescence (DIF) has long been considered the gold-standard test to predict immunological remission in pemphigus vulgaris (PV); however, there have been no comparisons between DIF and antidesmoglein (anti-Dsg) ELISA.

AIM:

To compare anti-Dsg ELISA with DIF in patients with PV for evaluation of immunological remission.

METHODS:

The study enrolled 46 patients with PV who had absence of any lesion, and had a daily prednisolone dosage of ≤ 10 mg without adjuvant drug treatment in the preceding 6 months. Biopsy specimens were taken from patients and processed for DIF. Intercellular deposition of IgG and/or C3 was considered positive. Serum samples were also collected for anti-Dsg1 and anti-Dsg3 ELISA, and an ELISA index value of > 20.0 was considered positive.

RESULTS:

DIF and anti-Dsg ELISA were positive for 11 (23.9%) and 18 patients (39.1%), respectively. Anti-Dsg ELISA had a sensitivity of 100%, a specificity of 80%, a positive predictive value of 61.1% and a negative predictive value of 100%.

CONCLUSIONS:

The high sensitivity of anti-Dsg ELISA proves that this simple serological test is a good substitute for DIF for evaluation of immunological remission in PV. As none of the DIF-positive patients was anti-Dsg-negative, it is possible that during the course of immunological remission, results for DIF may become negative before the results for Dsg ELISA do so.

• Authors: M Daneshpazhooh, K Kamyab, M-S Kalantari, K Balighi, Z S Naraghi, S Shamohammadi, S M-A Mortazavizadeh, A Ramezani, C Chams-Davatchi
• Journal: Clinical and experimental dermatology (Clin Exp Dermatol) Vol. 39 Issue 1 Pg. 41-7 (Jan 2014) ISSN: 1365-2230 [Electronic] England
• PMID: 23782219 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2013 British Association of Dermatologists.

Chemical References

• Autoantibodies
• Desmoglein 1
• Desmoglein 3
• Glucocorticoids
• Immunoglobulin G
• Prednisolone

Topics

• Adolescent
• Adult
• Aged
• Autoantibodies (blood, immunology)
• Desmoglein 1 (immunology)
• Desmoglein 3 (immunology)
• Enzyme-Linked Immunosorbent Assay (methods)
• Female
• Fluorescent Antibody Technique, Direct
• Glucocorticoids (therapeutic use)
• Humans
• Immunoglobulin G (immunology)
• Male
• Middle Aged
• Pemphigus (drug therapy, immunology)
• Predictive Value of Tests
• Prednisolone (therapeutic use)
• Sensitivity and Specificity
• Young Adult