Abstract:

Objective To evaluate the performance of desmoglein （Dsg）1 enzyme-linked immunosorbent assay （ELISA） in the detection of serum antibodies in patients with pemphigus foliaceus （PF）. Methods Sera were obtained from 80 patients with PF and 132 human controls including 33 patients with bullous pemphigoid, 3 patients with linear IgA bullous dermatosis, 2 patients with acquired bullous epidermolysis, 20 patients with systemic lupus erythematosus （SLE）, etc, and subjected to a random and blind test by Dsg1 ELISA and indirect immunofluorescence （IIF） on monkey oesophagus. Results The Dsg1 ELISA was positive in 75（93.8%） patients with PF and 5 （3.8%） human controls （including 1 case of bullous pemphigoid, 1 case of SLE, 1 case of dermatomyositis, 1 case of eczema and 1 normal human control with indeterminate value）, and IIF was positive in 71（88.8%） patients with PF, but in none of the controls. The sensitivity and specificity was 93.8% （95% CI : 0.85 - 0.98） and 96.2% （95% CI : 0.91 - 0.99） respectively for Dsg1 ELISA in the serodiagnosis of PF, 88.8% （95% CI : 0.82 - 0.96） and 100% （95% CI : 0.96 - 1.00） respectively for IIF. There was no statistical difference in the sensitivities （P = 0.289） or specificities （P = 1.000） between the two test methods. Conclusions Dsg1 ELISA is a simple, sensitive and specific serological detection method, and can serve as an adjunct in the diagnosis of PF.

Key words: enzyme-linked immunosorbent assay, pemphigus foliaceus, indirect immunofluorescence, desmoglein1