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García-Lechuga M, Vega-Memije ME, Montiel-Rangel AI, Torres-González A, Rangel-Gamboa L. Utility of IgG4 immunohistochemistry detection in pemphigus diagnosis. SAGE Open Med Case Rep 2022; 10:2050313X211072982. [PMID: 35070321 PMCID: PMC8777340 DOI: 10.1177/2050313x211072982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 12/21/2021] [Indexed: 11/16/2022] Open
Abstract
Pemphigus includes a group of blistering autoimmune diseases that affect the skin and mucosa, characterized by the formation of epidermal bullous and the presence of antibodies against binding proteins. Pemphigus is classified according to clinical presentation, target molecule, and IgG production as pemphigus vulgaris, foliaceous, IgA-pemphigus, and paraneoplastic pemphigus. Thus, the identification of autoantibodies class and site of deposition is mandatory. The gold standard to identify the immune complex deposition is the direct immunofluorescences technique, performed in fresh tissue; unfortunately, this method is unavailable in the regional hospital at the Mexican provinces. Nevertheless, IgG subclass-4 is the prevalence of immunoglobulin in acantholysis. Therefore, this IgG subclass could be detected using IgG4 immunohistochemistry. Because direct immunofluorescences technique is absent in provinces or patients denied a new biopsy to confirm the diagnosis, this work presented pemphigus vulgaris confirmation using the IgG4 immunohistochemistry technique in patients with clinical lesions suggestive of pemphigus vulgaris and intraepidermal blister manifestation in histopathology.
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Affiliation(s)
- Maricela García-Lechuga
- Departamento de Medicina Interna, Hospital General de Zona No.71 “Benito Coquet,” Veracruz, México
| | - María Elisa Vega-Memije
- Departamento de Dermatopatología, Hospital General “Dr. Manuel Gea González,” Ciudad de México, México
| | | | - Andres Torres-González
- Departamento de Medicina Interna, Hospital General de Zona No.71 “Benito Coquet,” Veracruz, México
| | - Lucia Rangel-Gamboa
- Consulta de Dermatología, Luminox Skin Centre, Torre Noox, Ciudad de México, México
- Departamento de Ecología e Agentes Patógenos, Subdirección de Investigación, Hospital General “Dr. Manuel Gea González,” Ciudad de México, México
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