015
Test #
Desmoglein (Dsg3 & Dsg1) Antibodies (ELISA)
CPT Code(s) #
83520 x2
If Profile, Includes Tests:
N/A
Disease Name:
Pemphigus, paraneoplastic pemphigus (PNP)/paraneoplastic autoimmune multiorgan syndrome (PAMS)
Type of Study:
Serum
Methodology:
ELISA
Substrate:
N/A
Reference Range:
Dsg1
• Negative: Ratio < 1.0
• Positive: Ratio ≥ 1.0
Dsg3
• Negative: Ratio < 1.0
• Positive: Ratio ≥ 1.0
Units:
Ratio
Schedule:
Assay performed once weekly. Report availability is within 7 days from time of specimen receipt.
Specimen Requirements:
Serum: Serum Separator Tube or red top tube, 5-10 mL preferred, 0.5 mL minimum sample volume. Separate serum from cells ASAP or within 2 hours of collection.
Sample Stability:
Storage & Stability:
Room temperature = 3 days
2-8ºC = 7 days
-15ºC to -25ºC = samples in long-term storage
Clinical Relevance:
Pemphigus includes a group of often fatal autoimmune blistering diseases characterized by intraepidermal and/or intraepithelial lesions. Pemphigus vulgaris and its variants may present with oral or other mucosal lesions alone or with mucosal plus skin lesions. Pemphigus foliaceus and its variants present with skin lesions alone. Indirect Immunofluorescence studies reveal that both forms of pemphigus are caused by autoantibodies to cell surface antigens of stratified epithelia of mucous membranes and epidermal layer of the skin. These antibodies bind to calcium dependent adhesion molecules in cell surface desmosomes, notably desmoglein 1(DSG-1) in pemphigus foliaceus and desmoglein 3 (DSG-3) in pemphigus vulgaris. Pemphigus vulgaris patients with both mucosal and skin lesions have antibodies to both DSG-3 and DSG-1. The diagnosis of pemphigus depends on biopsy and serum studies that characterize lesions and detect the autoantibodies that cause them. Serum studies afford highly sensitive diagnostic aids. Originally they were performed by indirect immunofluorescence using monkey esophagus and other tissues sections. The identification of the reactive antigens as DSG-1 and DSG-3 has made it possible to develop highly specific and sensitive ELISA methods.
