title: Diagnostic relevance of direct immunofluorescence in ocular mucous membrane pemphigoid.
abstract: OBJECTIVE
  The objective was to determine the diagnostic value of direct immunofluorescence (DIF) in ocular mucous membrane pemphigoid (ocular MMP), taking into account immunofluorescence patterns and biopsy sites.
  
  
  METHODS
  DIF results and medical records of 54 patients with a suspected diagnosis of ocular MMP were reviewed.
  
  
  RESULTS
  There was an overall prevalence of ocular MMP in 70.4 % of cases. Linear deposition of IgA, IgG, or C3 showed a high positive predictive value (84-100 %). Sensitivity and negative predictive value of IgG, IgM, IgG, and C3 in DIF were higher in cutaneous samples than in conjunctival biopsies, thus yielding a higher diagnostic accuracy. The sensitivity of DIF in ocular MMP seems to be lower than in bullous pemphigoid.
  
  
  CONCLUSIONS
  The diagnostic value of DIF in the workup of ocular MMP was confirmed. However, biopsies taken from non-conjunctival, cutaneous tissue appear to yield more accurate results.
authors.affiliation: Department of Dermatology, Eberhard-Karls-University, Tübingen, Germany.|Medical Directorate, University Hospital of Zurich, Rämistrasse 100, Zurich, Switzerland.
authors.forename: Tarun
authors.initials: T
authors.lastname: Mehra
authors.affiliation: Department of Dermatology, Eberhard-Karls-University, Tübingen, Germany.|Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.
authors.forename: Emmanuella
authors.initials: E
authors.lastname: Guenova
authors.affiliation: Department of Psychiatry, University of Basel, Wilhelm Klein-Strasse, Basel, Switzerland.
authors.forename: Frieder
authors.initials: F
authors.lastname: Dechent
authors.affiliation: Center for Ophthalmology, Eberhard- Karls-University, Tübingen, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Würth
authors.affiliation: Center for Ophthalmology, Eberhard- Karls-University, Tübingen, Germany.
authors.forename: Manfred
authors.initials: M
authors.lastname: Zierhut
authors.affiliation: Department of Dermatology, Eberhard-Karls-University, Tübingen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Röcken
authors.affiliation: Department of Dermatology, Eberhard-Karls-University, Tübingen, Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Schaller
authors.affiliation: Center for Ophthalmology, Eberhard- Karls-University, Tübingen, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Deuter
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis; D016207:Cytokines / Q000276:immunology*; D005260:Female; D019085:Fluorescent Antibody Technique, Direct / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010390:Pemphigoid, Benign Mucous Membrane / Q000175:diagnosis* / Q000276:immunology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D016207:Cytokines