Muglia Christine, Bronsnick Tara, Kirkorian A Yasmine, Cha Jisun
Department of Medicine, Rutgers-New Jersey Medical School, Newark, USA.
Department of Dermatology, Rutgers-Robert Wood Johnson Medical School, Somerset, New Jersey, USA.
Cutis. 2017 Jan;99(1):E27-E30.
The reported sensitivity and specificity of enzyme-linked immunosorbent assay (ELISA) for bullous pemphigoid (BP) diagnosis is approximately 87% and 98%, respectively. These statistics suggest that ELISA is a reliable diagnostic test; therefore, the use of ELISA for BP diagnosis has increased. We report the case of a man who was diagnosed with BP and was treated for 3 years based on a positive ELISA for IgG against BP180. After reevaluation, his revised diagnosis was not consistent with BP based on clinical presentation, histopathology, and direct immunofluorescence (DIF). Reviewing reports of ELISA for BP diagnosis in the literature revealed several issues including dissimilar diagnostic procedures and patient populations, multiple reports of positive ELISA in patients without BP, and lack of explanation for these false-positives. This case report and review of the literature is a cautionary tale regarding the use of ELISA as an independently reliable test for BP diagnosis.
据报道，酶联免疫吸附测定（ELISA）用于大疱性类天疱疮（BP）诊断的敏感性和特异性分别约为87%和98%。这些统计数据表明ELISA是一种可靠的诊断测试；因此，ELISA在BP诊断中的应用有所增加。我们报告一例男性病例，该患者被诊断为BP，并基于抗BP180 IgG的ELISA阳性接受了3年治疗。重新评估后，根据临床表现、组织病理学和直接免疫荧光（DIF），其修订诊断与BP不一致。回顾文献中关于ELISA用于BP诊断的报告发现了几个问题，包括不同的诊断程序和患者群体、无BP患者中多次出现ELISA阳性报告以及对这些假阳性缺乏解释。本病例报告及文献回顾警示人们，将ELISA用作BP诊断的独立可靠测试需谨慎。
