Diagnostic relevance of direct immunofluorescence in ocular mucous membrane pemphigoid

J Dtsch Dermatol Ges. 2015 Dec;13(12):1268-74. doi: 10.1111/ddg.12716.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • 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*
  • Pemphigoid, Benign Mucous Membrane / immunology*
  • Reproducibility of Results
  • Sensitivity and Specificity

Substances

  • Biomarkers
  • Cytokines