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Correlation between dermal interstitial immunoglobulin G and hypergammaglobulinemia
C Brown1, T S Lieu, R D Sontheimer
1Department of Dermatology, University of Texas Southwestern Medical Center, Dallas 75235-9069.
The Journal of Investigative Dermatology
|August 1, 1991
Summary
Diffuse dermal immunofluorescence (DDIF) in skin biopsies is a real biological finding, not an artifact. This finding reflects elevated serum immunoglobulin G (IgG) levels in patients.
Area of Science:
- Immunology
- Dermatology
- Microscopy
Background:
- Diffuse dermal immunofluorescence (DDIF) in skin biopsies is often dismissed as an artifact.
- However, this study investigates DDIF as a potential in vivo indicator of elevated serum immunoglobulin G (IgG).
Purpose of the Study:
- To determine if DDIF is a true biological phenomenon linked to elevated serum IgG levels.
- To correlate DDIF intensity and elution quantities with serum gamma globulin levels.
Main Methods:
- A blinded prospective study compared DDIF in patients with and without hypergammaglobulinemia.
- Methods included direct immunofluorescence microscopy, anti-human IgG antibody titration, and IgG elution from skin biopsies.
- Quantification of eluted IgG was performed using solid-phase immunoassay.
Main Results:
- A trend of increased DDIF intensity correlated with higher serum gamma globulin levels.
- A significant positive correlation was found between DDIF endpoint titers and serum gamma globulin levels (p=0.05, r=0.429).
- The strongest correlation was between eluted IgG quantities and serum gamma globulin levels (p=0.01, r=0.599).
Conclusions:
- DDIF is a genuine biological phenomenon reflecting elevated serum gamma globulin levels.
- Overnight elution of dermal IgG can reveal disease-related IgG, suggesting DDIF's diagnostic potential.