title: Childhood bullous pemphigoid: clinical and immunological findings in a series of 4 cases.
abstract: BACKGROUND
  Bullous pemphigoid (BP) is an autoimmune blistering disease that is rare in childhood. As in adult BP, antibodies against the 180-kDa antigen (BP180) seem to be involved in the pathogenesis of the disease, but, to date, only a small number of children with the disease have been examined immunologically.
  
  
  METHODS
  We report the cases of 4 infants with BP aged 5 to 12 months. All of them had involvement of the hands and feet, and they all achieved a complete remission in less than 6 months when treated with oral prednisolone stearoyl glycolate. Three patients could be examined using antigen characterization techniques. Autoantibodies against the NC16A domain of BP180 were found by immunoblot assay in all 3 and by enzyme-linked immunosorbent assay in 2 of them. Interestingly, although IgA autoantibodies were detected in only 1 of them by indirect immunofluorescence, all of them had IgA autoantibodies, and 2 of the 3 had IgG autoantibodies against NC16A as detected by immunoblot assay. One patient also had IgG autoantibodies against the carboxyterminal domain of BP180.
  
  
  CONCLUSIONS
  IgA-specific antibodies against BP180 were detected in all our patients. These findings further raise the question about the relationship between BP and linear IgA bullous dermatosis, the most common autoimmune blistering disorder in children.
authors.affiliation: Department of Dermatology, Hospital Clinic, Barcelona, Spain. 34199mmd@comb.es
authors.forename: Maria Isabel
authors.initials: MI
authors.lastname: Martinez-De Pablo
authors.forename: Maria Antonia
authors.initials: MA
authors.lastname: González-Enseñat
authors.forename: Asunción
authors.initials: A
authors.lastname: Vicente
authors.forename: Montserrat
authors.initials: M
authors.lastname: Gilaberte
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Mascaró
mesh_terms: D001323:Autoantibodies / Q000097:blood*; D003176:Complement C3 / Q000378:metabolism*; D006801:Humans; D007223:Infant; D008297:Male; D010391:Pemphigoid, Bullous / Q000097:blood* / Q000473:pathology* / Q000628:therapy
chemical_list: D001323:Autoantibodies; D003176:Complement C3