Article
Anti-bullous pemphigoid 180 and 230 antibody dual-positivity: Possible surrogate for disease severity and/or predictor of need for systemic steroids in the initial diagnostic evaluation of bullous pemphigoid
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Authors
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M. Treidl-Khalifa
- Donauspital, SMZOst, Dermatologie, Wien, Österreich
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R. Florian
- Donauspital, SMZOst, Dermatologie, Wien, Österreich
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B. Volc-Platzer
- Donauspital, SMZOst, Dermatologie, Wien, Österreich
| Published: | July 16, 2018 |
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Outline
Text
Introduction: Bullous pemphigoid (BP) is the most common autoimmune blistering disease in elderly patients, and it is associated with significant morbidity and mortality. Systemic corticosteroids are effective in the treatment of BP but are correlated with high morbidity and mortality due to their adverse effects.
Aim: The aim of our study was to determine whether positivity of anti-BP 180 and/or anti-BP 230 immunoglobulin G (IgG) in the initial diagnostic work-up can be used as surrogate marker for disease severity and the need for systemic steroids within the first 6 months after diagnosis.
Methods: This was a retrospective analysis of patients diagnosed with BP at the Donauspital in Vienna, Austria, by using an enzyme-linked immunosorbent assay (ELISA) for anti-BP 180 (NC16a) and anti-BP 230 IgG.
Results: BP was diagnosed in 30 patients, who had a mean age of 81 years. In total, 22 individuals (14 men and 8 women) were included for further analysis. Of these, 13 (59%) were positive for anti-BP 180, and 7 (32%) were positive for both anti-BP 180 and anti-BP 230. No patients were positive for anti-BP 230 alone. Two (9%) patients were negative for both anti-BP 180 and anti-BP 230.
Discussion: There was a trend to inverse correlation between BP ELISA dual positivity results and disease severity.
Conclusions: Our data indicate that anti-BP 180 and anti-BP 230 positivity are surrogate markers for the risk of mortality. The incidence of BP which was higher in men (64%) than in women (36%) in our study. This is consistent with the results of prior studies. Male gender is associated with a higher mortality.
