Summary of results of serological tests and diagnoses for 4774 cases of various autoimmune bullous diseases consulted to Kurume University. (11th September 2016)

• Record Type: Journal Article
• Authors: Hashimoto, T.; Tsuruta, D.; Koga, H.; Fukuda, S.; Ohyama, B.; Komai, A.; Karashima, T.; Ohata, C.; Teye, K.; Ishii, N.
• Is Part Of: British journal of dermatology. Volume 175:Number 5(2016)
• Page Start: 953
• Page End: 965
• Publication Date: 2016-09-11
• Subjects: Dermatology -- Periodicals; Skin -- Diseases -- Periodicals; 616.5
• DOI: 10.1111/bjd.14692
• Languages: English
• ISSNs: 0007-0963

Abstract

Summary: Background: Although many new disease entities of autoimmune bullous disease (AIBD) have recently been recognized, satisfactory immunological diagnostic methods and comprehensive classifications for various AIBDs have not been established. Objectives: To identify immunological diagnostics and comprehensive classifications for AIBDs. Methods: We selected and examined 4774 patients with various AIBDs from our cohort of 5063 patients with difficult AIBDs, whose sera and information were sent for our diagnostic method from other institutes in either Japan or other countries over the last 19 years. We examined the sera by our immunological diagnostic methods including various immunofluorescence, immunoblotting and enzyme‐linked immunosorbent assay tests to make final diagnoses. Results: By our immunological diagnostic methods, we successfully made final diagnoses for approximately three‐quarters of the difficult cases of AIBD, although the remaining cases could not be diagnosed. Using the results, we suggest the most extensive and newest classification of AIBDs, and also propose the most efficient algorithm of immunological tests for the diagnosis of various AIBDs. Conclusions: The results in this study of 4774 patients with various AIBDs indicate that our immunological diagnostic method is useful for making diagnoses for most patients with AIBD. However, we need further improvements including new immunological techniques to establish more satisfactory methods. Abstract : What's already known about this topic? There are many different autoimmune bullous diseases (AIBDs) that are diagnosed by immunological tests, in addition to clinical and histopathological examinations. As one of the centres for diagnosis of AIBDs in Japan, we have collected sera and information for more than 5000 difficult cases of various AIBDs over the last 19 years, and have performed various serological tests. What does this study add? This study presents the current classification and algorithm for immunological diagnosis in AIBDs. This study also presents the final diagnoses for our 4774 patients with AIBDs, which were made by our immunological diagnostic method. What is the translational message? This study proposes a comprehensive novel classification of AIBDs, which should be useful for precise and detailed diagnoses of various AIBDs in the clinical field. The large number of immunological and molecular methods described in this study should also facilitate clinical practice, such as for diagnoses and appropriate selection of treatments, for various AIBDs. Video Commentary