Direct immunofluorescence study in autoimmune bullous disorders of skin

Deepthi P Kambi,Santosh C S,Abhishek Vijayakumar,Gopal M G,Sugnua B V

doi:10.7439/ijbar.v4i9.467

Deepthi P Kambi, Santosh C S + Show 3 more

Open Access

https://doi.org/10.7439/ijbar.v4i9.467

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Abstract

Background and objectives: This study was taken up to know the utility of application of Direct Immunofluorescence on skin biopsies with particular reference to Autoimmune Bullous disorders. The objectives of the present study was to detect specific patterns of DIF in different Autoimmune bullous disorders, to supplement clinical and histopathological features, and hence for confirmatory diagnosis of these disorders. Methods: DIF using fluorescent labelled antibodies IgG, IgM, IgA and C3 - was carried out in 60 clinically suspected cases of Autoimmune bullous disorders referred to Department of Pathology, KIMS Hospital and Research Center, Bangalore, over a period of 18 months from January 2011 to July 2012. Results: Out of 60 cases analysed, 39 cases were given a final diagnosis as Autoimmune bullous disorder based on clinical, histopathological and DIF findings. DIF positivity was observed in 34 cases. DIF findings correlated with clinical and histopathological findings in 37 cases (94.8%). Interpretation and Conclusion: In this study we found out that DIF serves as a simple, highly sensitive, cost-effective and hence gold standard test for Autoimmune bullous disorders. The technique is essential to supplement clinical findings and histopathology in the diagnosis of these Immunobullous disorders.

Highlights

Immunofluorescence is a histochemical laboratory staining technique used for demonstrating the presence of antibodies bound to antigens in tissue or circulating body fluids[1].Coons et al 2 first described the technique of fluorescent antibody studies in 1942, while Burnham et al[3] were the first to report a fluorescent band in the dermoepidermal junction in Lupus Erythematosus
2.5 Method of collection of Data: A detailed history was taken and clinical examination done of patients and those who were clinically diagnosed to have immmuno bullous disorder were selected and biopsy done from the fresh vesicle for histopathology and from the adjacent skin for DIF
Autoimmune Bullous disorders are a heterogenous group of diseases characterized by antibodies to structural components of the skin and mucous membranes[5]

Summary

Introduction

Immunofluorescence is a histochemical laboratory staining technique used for demonstrating the presence of antibodies bound to antigens in tissue or circulating body fluids[1].Coons et al 2 first described the technique of fluorescent antibody studies in 1942, while Burnham et al[3] were the first to report a fluorescent band in the dermoepidermal junction in Lupus Erythematosus. The technique is essential to supplement clinical findings and histopathology in the diagnosis of Immunobullous disorders It permits early diagnosis, treatment and subsequent monitoring of disease activity in patients with these lifethreatening diseases[1]. This study was taken up to know the utility of application of Direct Immunofluorescence on skin biopsies with particular reference to Autoimmune Bullous disorders. Methods: DIF using fluorescent labelled antibodies – IgG, IgM, IgA and C3 - was carried out in 60 clinically suspected cases of Autoimmune bullous disorders referred to Department of Pathology, KIMS Hospital and Research Center, Bangalore, over a period of 18 months from January 2011 to July 2012. The technique is essential to supplement clinical findings and histopathology in the diagnosis of these Immunobullous disorders.

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