Usefulness of BP180 NC16a enzyme-linked immunosorbent assay in the serodiagnosis of pemphigoid gestationis and in differentiating between pemphigoid gestationis and pruritic urticarial papules and plaques of pregnancy.
BACKGROUND
Pemphigoid gestationis (PG) is a rare pregnancy-associated subepidermal immunobullous disease that targets hemidesmosomal proteins, particularly BP180. Clinically, PG can resemble the eruption known as polymorphic urticarial papules and plaques of pregnancy (PUPPP), and accurate differentiation between these 2 pruritic pregnancy dermatoses has important implications for fetal and maternal prognoses. Results of epitope mapping studies show that IgG autoantibodies in up to 90% of PG serum samples target the well-defined membrane-proximal NC16a domain of BP180.


OBJECTIVE
To examine the usefulness of a commercially available NC16a domain enzyme-linked immunosorbent assay in the serodiagnosis of PG and in the differentiation of PG from PUPPP.


METHODS
A total of 412 women consisting of pretreatment patients with PG (n = 82), patients with PUPPP (n = 164), and age- and sex-matched controls (n = 166).


METHODS
All serum samples were assayed in duplicate. Receiver operating characteristic analyses were performed to determine a cutoff value for the diagnosis of PG and for differentiation from PUPPP and controls.


RESULTS
A cutoff value of 10 enzyme-linked immunosorbent assay units was associated with specificity and sensitivity of 96%.


CONCLUSIONS
The NC16a enzyme-linked immunosorbent assay is highly sensitive and highly specific in differentiating PG from PUPPP, and it is potentially a valuable tool in the serodiagnosis of PG.
Powell
Ann Marie
AM
Department of Dermatological Immunopathology, St John's Institute of Dermatology, St Thomas' Hospital, London, England.
Sakuma-Oyama
Yohko
Y
Oyama
Noritaka
N
Albert
Sandra
S
Bhogal
Balbir
B
Kaneko
Fumio
F
Nishikawa
Takeji
T
Black
Martin M
MM
D000328:Adult; D001324:Autoantigens; D001707:Biopsy, Needle; D016022:Case-Control Studies; D016001:Confidence Intervals; D003937:Diagnosis, Differential; D004797:Enzyme-Linked Immunosorbent Assay / Q000379:methods; D005069:Evaluation Studies as Topic; D005260:Female; D005865:Gestational Age; D006801:Humans; D007150:Immunohistochemistry; D024041:Non-Fibrillar Collagens; D010391:Pemphigoid, Bullous / Q000097:blood / Q000175:diagnosis*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D011336:Probability; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012698:Serologic Tests / Q000379:methods; D012720:Severity of Illness Index; D012872:Skin Diseases, Vesiculobullous / Q000175:diagnosis; D014581:Urticaria / Q000097:blood / Q000175:diagnosis*; D000097805:Collagen Type XVII
D001324:Autoantigens; D024041:Non-Fibrillar Collagens; D000097805:Collagen Type XVII