Pathology Handbook

Pemphigus/Pemphigoid Antibodies

Clinical Indications

Bullous pemphigoid

Pemphigus vulgaris

Pemphigus foliaceus

Paraneoplastic pemphigus

Please note:  Any sample found to be Positive should be confirmed by skin biopsy. Any patient found to be Negative, but with clinical features suggestive of bullous skin disease should have a skin biopsy performed.

Test includes

Detection of relevant antibody (usually IgG or IgA) to various antigens in the epithelium, cell surface or to the basement membrane zone (BMZ).

Request Form 

Request on ICE

Availability

Assay performed when sufficient samples received.

Patient preparation

No special preparation is required.

Specific Criteria

It is essential to provide relevant clinical information.

Turnaround Time

All samples are generally sent to  referral laboratory  within 3 working days of receipt in the laboratory. The assay is performed when sufficient samples are received.

Specimen

Red top tube. Gold top tube will be accepted.

Volume

7 ml

Container

Vacutainer red top

Collection

Samples should be transported to the laboratory as soon as is practicably possible.

Lab Handling

Aliquot and store at 4-8°C prior to testing and at -20°C or below for up to 1 month after receipt.

Causes for Rejection

Unlabelled/inadequately labelled sample.

Inadequately completed request form.

Delay in sample reaching laboratory.

Reference Range

A qualitative result is given and samples are reported as Positive, Weak Positive or Negative.

Listed below are the immunofluorescence patterns and their associated skin diseases:

Pemphigus vulgaris: IgG autoantibodies to epidermal cell surface antigens of stratified squamous epithelia. Characteristic 'chicken wire pattern'.

Pemphigus foliaceus: IgG autoantibodies to intercellular spaces of stratified squamous epithelia.

Paraneoplastic pemphigus: IgG autoantibodies to epithelium cell surfaces and BMZ.

IgA pemphigus: IgA autoantibodies to subcorneal or intercellular spaces of squamous epithelia.

Bullous pemphigoid: IgG autoantibodies to BMZ.

Please note this is not an exhaustive list.