Diagnosis of paraneoplastic pemphigus (PNP) depends on the demonstration of antiplakin antibodies. A. This can be accomplished by indirect
immunofluorescence of patient serum on rodent urinary bladder demonstrating binding of immunoglobulin G to the cell surface of transitional epithelial
cells. A positive result implies the presence of antiplakin antibodies. This technique, although easily performed, has the lowest sensitivity and specificity. B.
Immunoblotting against epidermal cell extracts is much more sensitive and specific. This shows detection of envoplakin (210 kDa) and/or periplakin (190
kDa) in 15 patients with PNP. Lane 16 is a normal control, and lane 17 shows a monoclonal antibody against periplakin. This technique uses denatured
antigen extracts, so it does not reliably detect some of the PNP antigens, but antibodies against the most characteristic plakin antigens, envoplakin and
Source: Chapter 55. Paraneoplastic Pemphigus, Fitzpatrick's Dermatology in General Medicine, 8e
periplakin, are easily detected. C. Immunoprecipitation using radiolabeled, nondenatured epidermal extracts and serum from a patient with PNP and
Citation:(PV).
Goldsmith
Katz
Gilchrest
BA,serum
Palleridentifies
AS, Leffell
Wolff
K. Fitzpatrick's
Dermatology
General Medicine,
8e; as
2012
Available
pemphigus vulgaris
In this LA,
case,
theSI,
PNP
patient's
allDJ,
of the
plakin
antigens. Envoplakin
andindesmoplakin
II migrate
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at
at:
http://mhmedical.com/
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July
28,
2017
210 kDa. This technique is the most sensitive and specific test for demonstration of antiplakin antibodies in PNP, but has limited availability. Although this
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technique readily
detects
the McGraw-Hill
antiplakin antibodies,
3 is not always efficiently identified, and this is best shown by using enzyme-linked
immunosorbent assay (ELISA).