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Diagnostic Value and Practicability of Serration Pattern Analysis by Direct Immunofluorescence Microscopy in Pemphigoid Diseases

In pemphigoid diseases, direct immunofluorescence can be used to differentiate 2 patterns of antibody deposition at the dermal–epidermal junction; u- and n-serrated pattern. The u-serrated pattern is found in epidermolysis bullosa acquisita, and n-serrated pattern in all other pemphigoid diseases. T...

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Autores principales: HOLTSCHE, Maike Marleen, VAN BEEK, Nina, KÜNSTNER, Axel, BUSCH, Hauke, ZILLIKENS, Detlef, SCHMIDT, Enno
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Society for Publication of Acta Dermato-Venereologica 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9366507/
https://www.ncbi.nlm.nih.gov/pubmed/33491096
http://dx.doi.org/10.2340/00015555-3748
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author HOLTSCHE, Maike Marleen
VAN BEEK, Nina
KÜNSTNER, Axel
BUSCH, Hauke
ZILLIKENS, Detlef
SCHMIDT, Enno
author_facet HOLTSCHE, Maike Marleen
VAN BEEK, Nina
KÜNSTNER, Axel
BUSCH, Hauke
ZILLIKENS, Detlef
SCHMIDT, Enno
author_sort HOLTSCHE, Maike Marleen
collection PubMed
description In pemphigoid diseases, direct immunofluorescence can be used to differentiate 2 patterns of antibody deposition at the dermal–epidermal junction; u- and n-serrated pattern. The u-serrated pattern is found in epidermolysis bullosa acquisita, and n-serrated pattern in all other pemphigoid diseases. To determine the detection frequency of these serrated patterns and the optimal thickness of biopsy cryosections, 2 patient cohorts obtained form our routine autoimmune laboratory were analysed; a retrospective cohort (n = 226) and a prospective cohort (n = 156). In 76% (291/382) of biopsies, a pattern was recognized, of which 96% (278/291) and 4% (13/291) had an n- or u-serrated pattern, respectively. A u-serrated pattern was seen in all epidermolysis bullosa acquisita biopsies confirmed by serology. No antibodies against type VII collagen were detected in any of the sera from biopsies with n-serrated pattern. No differences between the detection frequencies of serrated pattern were seen with respect to age, sex, biopsy site, or section thickness, while the detection frequency was higher in patients with serum anti-BP180 reactivity compared with those without. In conclusion, serrated pattern analysis using direct immunofluorescence has a high detection frequency and specificity for epidermolysis bullosa acquisita and will further facilitate the diagnosis of latter disorder.
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spelling pubmed-93665072022-10-20 Diagnostic Value and Practicability of Serration Pattern Analysis by Direct Immunofluorescence Microscopy in Pemphigoid Diseases HOLTSCHE, Maike Marleen VAN BEEK, Nina KÜNSTNER, Axel BUSCH, Hauke ZILLIKENS, Detlef SCHMIDT, Enno Acta Derm Venereol Clinical Report In pemphigoid diseases, direct immunofluorescence can be used to differentiate 2 patterns of antibody deposition at the dermal–epidermal junction; u- and n-serrated pattern. The u-serrated pattern is found in epidermolysis bullosa acquisita, and n-serrated pattern in all other pemphigoid diseases. To determine the detection frequency of these serrated patterns and the optimal thickness of biopsy cryosections, 2 patient cohorts obtained form our routine autoimmune laboratory were analysed; a retrospective cohort (n = 226) and a prospective cohort (n = 156). In 76% (291/382) of biopsies, a pattern was recognized, of which 96% (278/291) and 4% (13/291) had an n- or u-serrated pattern, respectively. A u-serrated pattern was seen in all epidermolysis bullosa acquisita biopsies confirmed by serology. No antibodies against type VII collagen were detected in any of the sera from biopsies with n-serrated pattern. No differences between the detection frequencies of serrated pattern were seen with respect to age, sex, biopsy site, or section thickness, while the detection frequency was higher in patients with serum anti-BP180 reactivity compared with those without. In conclusion, serrated pattern analysis using direct immunofluorescence has a high detection frequency and specificity for epidermolysis bullosa acquisita and will further facilitate the diagnosis of latter disorder. Society for Publication of Acta Dermato-Venereologica 2021-03-09 /pmc/articles/PMC9366507/ /pubmed/33491096 http://dx.doi.org/10.2340/00015555-3748 Text en © 2021 Acta Dermato-Venereologica https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the CC BY-NC license
spellingShingle Clinical Report
HOLTSCHE, Maike Marleen
VAN BEEK, Nina
KÜNSTNER, Axel
BUSCH, Hauke
ZILLIKENS, Detlef
SCHMIDT, Enno
Diagnostic Value and Practicability of Serration Pattern Analysis by Direct Immunofluorescence Microscopy in Pemphigoid Diseases
title Diagnostic Value and Practicability of Serration Pattern Analysis by Direct Immunofluorescence Microscopy in Pemphigoid Diseases
title_full Diagnostic Value and Practicability of Serration Pattern Analysis by Direct Immunofluorescence Microscopy in Pemphigoid Diseases
title_fullStr Diagnostic Value and Practicability of Serration Pattern Analysis by Direct Immunofluorescence Microscopy in Pemphigoid Diseases
title_full_unstemmed Diagnostic Value and Practicability of Serration Pattern Analysis by Direct Immunofluorescence Microscopy in Pemphigoid Diseases
title_short Diagnostic Value and Practicability of Serration Pattern Analysis by Direct Immunofluorescence Microscopy in Pemphigoid Diseases
title_sort diagnostic value and practicability of serration pattern analysis by direct immunofluorescence microscopy in pemphigoid diseases
topic Clinical Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9366507/
https://www.ncbi.nlm.nih.gov/pubmed/33491096
http://dx.doi.org/10.2340/00015555-3748
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