A case of bullous pemphigoid with high levels of serum and blister fluid IgG antibodies to BP180 detected with ELISA, but absence of IgG, IgG1 and IgG4 deposits at the dermal-epidermal junction in direct immunofluorescence tests Przypadek pemfigoidu p cherzowego z wysokimi poziomami przeciwcia IgG wobec BP180 w surowicy i p ynie p cherzowym w te cie ELISA, lecz z brakiem z ogów IgG, IgG1 i IgG4 w po czeniu skórno-naskórkowym w bezpo rednich badaniach immunofluorescencyjnych

Bullous pemphigoid (BP) is the commonest autoimmune blistering disease. Blister formation in BP seems to be initiated by the autoantibodies directed against components of the hemidesmosome adhesion complex, namely BP180 and/or BP230. We present a case of BP with increased levels of serum and blister fluid anti-BP180 IgG antibodies detected with ELISA, in whom direct immunofluorescence tests (on both non-split and salt-split skin) revealed just C3, but not IgG,, IgG1 and IgG4 deposits, along the dermal-epidermal junction. Our opinion is, as for some researchers even the concept of ""BP"" seems to be disputable, that diagnosing BP should be based on careful consideration of all clinical and laboratory data available, but not merely on the result of a single laboratory test, even regarded at contemporary stage of our understanding of BP as the most valuable. To put it straightforwardly, the more clinical and laboratory features suggesting BP fulfilled, the better for eventual making of the diagnosis of BP.