Immunohistopathologic testing in patients suspected of ocular cicatricial pemphigoid.
OBJECTIVE
Optimizing the sensitivity of immunopathologic methods in detecting target antigens in immune-mediated cicatrizing conjunctivitis.


METHODS
Immunofluorescence was performed on normal and salt-split conjunctival biopsies in fifteen patients with clinical evidence of ocular cicatricial pemphigoid, and results were compared with immunoperoxidase, a technique thought to be more sensitive although more expensive and more difficult technically to perform.


RESULTS
Ten of fifteen biopsies (67%) were positive when conventional and salt-split immunofluorescence results were combined. Four of eight patients with positive conventional immunofluorescence showed more marked immunofluorescence with the salt-split method. All patients were positive with immunoperoxidase (100%).


CONCLUSIONS
Immunoperoxidase was more sensitive than conventional or salt-split immunofluorescence in detecting immunoreactant deposition along the basement membrane of the conjunctiva. Salt-split immunofluorescence demonstrated more intense staining of conjunctival samples when compared with conventional immunofluorescence, without however increasing the yield of positive biopsies. Finding solutions for the proper handling of conjunctival tissue in salt may improve the diagnostic yield of salt-split immunofluorescence.
Department of Ophthalmology, Bichat-Claude-Bernard Hospital, Paris, France.
P E
PE
Demers
H
H
Robin
C
C
Prost
M
M
Toutblanc
T
T
Hoang-Xuan
D000368:Aged; D000369:Aged, 80 and over; D001324:Autoantigens / Q000032:analysis; D001485:Basement Membrane / Q000473:pathology; D001706:Biopsy; D003228:Conjunctiva / Q000276:immunology / Q000473:pathology*; D003231:Conjunctivitis / Q000175:diagnosis* / Q000276:immunology; D005260:Female; D019085:Fluorescent Antibody Technique, Direct; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D010390:Pemphigoid, Benign Mucous Membrane / Q000175:diagnosis* / Q000276:immunology; D012680:Sensitivity and Specificity
D001324:Autoantigens