Ní Maolcatha Sarah, Nic Dhonncha Ellis, O'Connor Cathal, Dinneen Sinead, Heffron Cynthia C B B
Pathology Cork University Hospital Cork Ireland.
Dermatology South Infirmary Victoria University Hospital Cork Ireland.
Skin Health Dis. 2023 Jul 11;3(4):e205. doi: 10.1002/ski2.205. eCollection 2023 Aug.
The lupus band test (LBT) is a direct immunofluorescence (DIF) technique which shows a band of localised immunoglobulins at the dermo-epidermal junction in lesional, non-sun-exposed skin of patients with both systemic and cutaneous lupus erythematosus (LE), and in perilesional skin of patients with systemic LE. However, low sensitivity and poor concordance between histological and clinical diagnoses warrant a review of the application of the LBT in the diagnosis of LE.
To assess the sensitivity and specificity of the LBT in diagnosing LE following clinico-pathological correlation (CPC).
All cases sent to our pathology department between 2011 and 2018 for DIF with a clinical query of LE were reviewed. Data collection included demographic details, pathology requests, histology and DIF reports, clinical reports and diagnoses, and serology.
Of 256 histology requests, 9% ( = 23) had a positive LBT. This was discordant with the prevalence of LE diagnosis, as 46.3% were diagnosed with LE following CPC. The sensitivity and specificity of the LBT for LE was 17.6% and 98.8% respectively, with a positive predictive value of 92.9% and negative predictive value of 58.2%.
The LBT is not a sensitive diagnostic test for LE, but is highly specific, and should be considered as a supportive diagnostic tool for LE. This is the largest reported case series evaluating the efficacy of the LBT in the diagnosis of LE.
狼疮带试验（LBT）是一种直接免疫荧光（DIF）技术，在系统性红斑狼疮（LE）和皮肤型红斑狼疮患者的皮损非暴露部位皮肤以及系统性LE患者的皮损周围皮肤的真皮表皮交界处显示一条局部免疫球蛋白带。然而，低敏感性以及组织学诊断与临床诊断之间的低一致性使得有必要重新审视LBT在LE诊断中的应用。
在临床病理相关性（CPC）之后评估LBT诊断LE的敏感性和特异性。
回顾了2011年至2018年间送至我们病理科进行DIF检查且临床怀疑为LE的所有病例。数据收集包括人口统计学细节、病理检查申请、组织学和DIF报告、临床报告与诊断以及血清学检查。
在256份组织学检查申请中，9%（n = 23）的LBT呈阳性。这与LE诊断的患病率不一致，因为在CPC之后46.3%的患者被诊断为LE。LBT诊断LE的敏感性和特异性分别为17.6%和98.8%，阳性预测值为92.9%，阴性预测值为58.2%。
LBT并非诊断LE的敏感试验，但具有高度特异性，应被视为LE的辅助诊断工具。这是报道的评估LBT在LE诊断中疗效的最大病例系列。
