Sieben, N.E. (2019) Direct immunofluorescence is the correct reference test to diagnose mucous membrane pemphigoid, however additional serological tests are useful : A comparison between multiple diagnostic tests. thesis, Medicine.
Full text available on request.Abstract
Background Mucous membrane pemphigoid (MMP) is an autoimmune bullous disease characterized by erosions, blisters and scarring on the mucosa. The heterogeneity of symptoms and affected mucosal sites makes MMP difficult to identify, resulting in a diagnostic delay. Diagnosis is based on clinical presentation in combination with direct immunofluorescence microscopy (DIF). Purpose To assess the optimal diagnostic strategy for MMP. The diagnostic value of DIF is compared to indirect immunofluorescence (IIF), immunoblot and ELISA. The optimal mucosal site for DIF biopsy is examined. Method Retrospective study analysing patients with suspected MMP with clinical features of erosions, blisters and/or scarring on the mucosa, who had DIF biopsy and serology (at least IIF on salt split skin (IIF SSS)) performed between 2002 and march 2019. The affected mucosal sites and the biopsy location were collected and used in the analyses. Results and conclusion 792 patients were included of which 122 were diagnosed with MMP. DIF had the highest diagnostic value with sensitivity, between 83.3% and 90.0% . The specificity (98.8%), positive and negative predictive value (87.9% and 91.2%) of IIF SSS were also high and can be a good addition next to DIF. There was no significant difference in diagnostic value of DIF between the various mucosal areas. Our study showed a biopsy for DIF can be taken either from perilesional mucosa or healthy mucosa and an additional skin biopsy for DIF can be useful for diagnosis in case of negative DIF of mucosa.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Horváth, dr. B. and Rashid, drs. H. |
| Faculty: | Medical Sciences |
| Keywords: | Dermatology, Pemphigoid Disease, DiagnosticTests, Comparative Research |
| Date Deposited: | 14 Jul 2020 11:04 |
| Last Modified: | 14 Jul 2020 11:13 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2750 |
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