As Julian mentioned, we are doing dsg-1 and 3 antibodies quantitatively by ELISA. We are about to publish a series of 55 cases assessed at enrolment, then followed sequentially
in a substantial proportion. Changes in levels correlate very strongly with disease activity responses in MOST patients, but not all; this applies to dsg-3, not so much dsg-1, which are far less frequently positive in our patients. BUT please note that the Abs do not often disappear, even after ritux. They fall in proportion to clinical activity. That change appears to be useful, but don't expect them to go to zero. I think a yes/no answer would help with diagnosis, but not for follow-up. We also subtyped IgG1 and IgG4, but this didn't add much.
We do the test for medicare rebate.
David
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A/Prof David Fulcher, MBBS, PhD, FRACP, FRCPA
Clinical Immunologist and Immunopathologist,
Immunopathology, level 2,
Institute of Clinical Pathology and Medical Research (icpmr)
Westmead Hospital, Sydney, Australia
Ph: 612-9845-6933; Fax 612-9891-3889
