The BP180 IgG ELISA is superior to the BP230 IgG ELISA for diagnosing IgG-mediated subepidermal autoimmune blistering dermatoses

Introduction: The subepidermal autoimmune blistering dermatoses (SABD) are characterized clinically by the presence of cutaneous and/or mucosal blisters, histologically by subepidermal blister formation and immunologically by circulating and tissue-bound autoantibodies against the dermal-epidermal junction. Aim of the study: The aim of this study was to examine the diagnostic value (proportion of positive results) of two commercial tests, BP180 and BP230 IgG ELISAs, in routine laboratory diagnostics of IgG-mediated SABD in a setting of a Poland's university dermatology department. Material and methods: A total of 35 IgG-mediated SABD patients with newly diagnosed disease were examined. Serum samples were tested using commercialized BP180 and BP230 IgG ELISAs. Results: Among the 35 SABD patients, 25.7% had a positive BP230 IgG ELISA result and 77.14% had a positive BP180 IgG ELISA. With McNemar's test and exact Liddell's test performance was different between the 2 assays (exact Liddell's test, p=0.0003; McNemar’s test, p=0.0005). Conclusions: BP230 IgG ELISA should be performed only in SABD patients with negative BP180 IgG ELISA result or in bullous pemphigoid cases regarded as less typical clinically.