Research Methods

(1)

Misdiagnosis Association & Society, Seattle, WA, USA

Keywords

Pemphigus vulgarisRazi hospitalAnti-desmogleinAutoantibodiesPemphigus Disease Area Index (PDAI)Enzyme-linked immunosorbent assay (ELISA)

Population under study: 52 pemphigus vulgaris patients
Location: Razi Hospital in Tehran, Iran
Time: 2013–2014

Method

The author’s previously unpublished study presented herein is a cohort study of 52 new pemphigus vulgaris patients who were examined while hospitalized in the Razi Hospital during 2013–2014.

The inclusion criteria were:

1.

New pemphigus vulgaris patients with optical microscopy biopsy findings in accordance with pemphigus vulgaris disease and direct immunofluorescence in accordance with pemphigus vulgaris in the last month
2.

No history of receiving systemic corticosteroids with immunosuppressive dosages before the treatment (1 mg per kg of body weight for more than 5 days, 2 weeks before the treatment)
3.

Active cutaneous or mucosal disease such as blisters, crest erosions, and mucosal erosions
4.

Patients under treatment with prednisolone with dosage of 1 or 2 mg per kg of body weight, with or without adjuvant

Exclusion criteria:

1.

A subgroup of pemphigus that is not pemphigus vulgaris
2.

History of receiving systemic corticosteroids with immunosuppressive dosage
3.

Treated patients or old erosions (in the case of cutaneous diseases, it only includes hyperpigmentation after inflammation, and for mucosal erosions it only includes old ulcers)
4.

Severe disease cases, which are candidates of receiving drugs other than prednisolone in addition to normal immunosuppressive adjuvants (azathioprine, methotrexate, and mycophenolate mofetil), such as intravenous immunoglobulin (Ig), and biologic drugs such as rituximab
5.

Patients who leave the hospital or who are discharged from hospital due to different reasons such as personal reasons or transferring to other departments

Venous blood samples were taken from the patients on the first day, the serum of the patients’ samples were kept at −70 °C until the performance of an enzyme-linked immunosorbent assay (ELISA) test. The serums were thinned by 1:100 and analyzed by ELISA kit according to the instruction of the manufacturer (Euroimmun AG, Luebeck, Germany). Then anti-desmoglein (DSG) 3 and anti-DSG1 titers were reported for each sample. Numbers above 20 relative units (RU)/ml were taken as positive. For values higher than 200 RU/ml, the patients’ serum was thinned by 1/400 and the index value was calculated.

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