Conflict of interest: none declared.
Experimental Dermatology ● Original Article
Comparison of desmoglein 1 and 3 enzyme-linked immunosorbent assay and direct immunofluorescence for evaluation of immunological remission in pemphigus vulgaris
Article first published online: 18 JUN 2013
© 2013 British Association of Dermatologists
Clinical and Experimental Dermatology
Volume 39, Issue 1, pages 41–47, January 2014
How to Cite
Daneshpazhooh, M., Kamyab, K., Kalantari, M.-S., Balighi, K., Naraghi, Z. S., Shamohammadi, S., Mortazavizadeh, S. M.-A., Ramezani, A. and Chams-Davatchi, C. (2014), Comparison of desmoglein 1 and 3 enzyme-linked immunosorbent assay and direct immunofluorescence for evaluation of immunological remission in pemphigus vulgaris. Clinical and Experimental Dermatology, 39: 41–47. doi: 10.1111/ced.12187
- Issue published online: 17 DEC 2013
- Article first published online: 18 JUN 2013
- Manuscript Accepted: 27 FEB 2013
- Deputy of Research, Tehran University of Medical Sciences. Grant Number: ID 8800
Vol. 39, Issue 2, 271, Article first published online: 13 FEB 2014
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.
To compare anti-Dsg ELISA with DIF in patients with PV for evaluation of immunological remission.
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.
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%.
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.