Eckardt Julia, Eberle Franziska C, Ghoreschi Kamran
Department of Dermatology, University Medical Centre, Eberhard Karls University Tübingen, Germany.
Eur J Dermatol. 2018 Feb 1;28(1):3-12. doi: 10.1684/ejd.2017.3166.
Bullous pemphigoid (BP) is the most common autoimmune blistering disease of the skin requiring skin and serum tests for a precise diagnosis.
We analysed the sensitivity and specificity of BP-relevant parameters and the value of autoantibody titres during follow-up of BP patients.
MATERIALS & METHODS: In a retrospective single-centre study, we included 200 consecutive patients with BP and 400 non-BP patients, and evaluated the test results of patients' serum and skin. In addition, we followed patients' autoantibody titres and clinical characteristics.
BP180-ELISA revealed the highest sensitivity (85.0%; specificity: 93.9%), while BP230-ELISA demonstrated the lowest sensitivity (55.5%; specificity: 92.9%). Direct and indirect immunofluorescence showed comparable results for sensitivity (77.2%/72.7%) and specificity (94.9%/93.7%). The sensitivity for skin histology was 76.3% (specificity: 81.3%). Longitudinal analysis showed significant changes in autoantibody titres.
BP diagnostics should include serum tests for BP autoantibodies and skin immunofluorescence. Skin histology is supportive for diagnosis. Autoantibody titres are markers for disease activity.
大疱性类天疱疮（BP）是最常见的自身免疫性皮肤水疱病，需要进行皮肤和血清检测以明确诊断。
我们分析了BP相关参数的敏感性和特异性以及BP患者随访期间自身抗体滴度的价值。
在一项回顾性单中心研究中，我们纳入了200例连续的BP患者和400例非BP患者，并评估了患者血清和皮肤的检测结果。此外，我们跟踪了患者的自身抗体滴度和临床特征。
BP180-ELISA显示出最高的敏感性（85.0%；特异性：93.9%），而BP230-ELISA的敏感性最低（55.5%；特异性：92.9%）。直接和间接免疫荧光在敏感性（77.2%/72.7%）和特异性（94.9%/93.7%）方面显示出可比的结果。皮肤组织学的敏感性为76.3%（特异性：81.3%）。纵向分析显示自身抗体滴度有显著变化。
BP的诊断应包括检测BP自身抗体的血清检测和皮肤免疫荧光。皮肤组织学有助于诊断。自身抗体滴度是疾病活动的标志物。
