Document Detail


Laboratory diagnosis of paraneoplastic pemphigus.
MedLine Citation:
PMID:  23796242     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Paraneoplastic pemphigus (PNP) is a multiorgan disease characterized by antibodies against plakins, desmogleins and the alpha-2-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)-ELISA, indirect immunofluorescence (IIF) on rat bladder, radioactive immunoprecipitation and a non-radioactive combined immunoprecipitation-immunoblot assay. Additional assays included BP180-ELISA and BP230-ELISA. We included sera of 19 PNP and 40 control patients.
RESULTS: The sensitivities were 63% for anti-EP ELISA, 74% for rat bladder IIF, 89% for immunoblotting, 95% for radioactive immunoprecipitation and 100% for non-radioactive immunoprecipitation. Specificities ranged from 86-100%. 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. Analysis of sequential PNP sera showed that antibody titers may decrease over time, possibly resulting in negative outcomes for envoplakin-ELISA and rat bladder-IIF studies.
CONCLUSIONS: Detection of autoantibodies against envoplakin 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. This article is protected by copyright. All rights reserved.
Authors:
A M Poot; G F H Diercks; D Kramer; I Schepens; G Klunder; T Hashimoto; L Borradori; M F Jonkman; H H Pas
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-6-25
Journal Detail:
Title:  The British journal of dermatology     Volume:  -     ISSN:  1365-2133     ISO Abbreviation:  Br. J. Dermatol.     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-6-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0004041     Medline TA:  Br J Dermatol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
This article is protected by copyright. All rights reserved.
Affiliation:
Center for Blistering Diseases, Department of Dermatology, University Medical Center Groningen, University of Groningen, the Netherlands.
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