Edwards, G. (Gareth) (2019) Diagnostic utility of C4d in bullous pemphigoid. thesis, Medicine.
Full text available on request.Abstract
Bullous pemphigoid is the most common disease of the rare group of subepidermal autoimmune bullous diseases with an average incidence rate of up to 4.3 per 100.000 people per year. It classically manifests itself with intense pruritus and large, tense serous or haemorrhagic blisters that appear in clusters on urticarial, erythematous, eczematous or even normal skin. While IgG-autoantibodies are confirmed to have a large importance in the pathophysiology of the disease, the importance of the complement system has been discussed for multiple decades. In the diagnostics of bullous pemphigoid, immunofluorescence is an integral technique, testing for IgG-autoantibodies and C3c complement. A study from Romeijn et al. showed that in a cohort of 300 patients, 17% did not show deposition of C3c complement. Case reports like Kassaby et al. showed that C4d complement, which has a longer half-life than C3c, can also be found in patient biopsies. In this thesis, the deposition of C4d complement was tested in C3c-negative and C3c-positive frozen biopsies from patients with bullous pemphigoid to test if C4d is more sensitive and specific than C3c. Methods A list of frozen biopsies from C3c-negative patients with bullous pemphigoid was provided by the UMCG, categorizing patients into two groups: IgG-negative and IgG-positive. Biopsies were searched out, cut into slides and stained for IgG, C3c and C4d. A total of 69 patients were tested after inclusion and exclusion criteria, of which 59 were negative and 10 were positive for C3c-complement. The stainings were then interpreted under a fluorescent microscope. Results A total of 20 patients tested definitively positive for C4d complement, while 12 were dubious
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Faculty supervisor: and Horvath, Dr. B. and Second supervisor: and Dr. G.F.H. Diercks and Institution: Department for Dermatology at the UMCG |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:46 |
| Last Modified: | 25 Jun 2020 10:46 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/714 |
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