Open AccessAtypical Pemphigus with Concomitant IgG and IgA Anti-Intercellular Autoantibodies Associated with Monoclonal IgA Gammopathy
Author(s) -
Haruhiko Ohno,
Shuji Miyagawa,
Toshihiro Hashimoto,
Akemi Nakagawa,
Kazuhiro Watanabe,
Takeji Nishikawa,
Toshihiko Shirai
Publication year - 1994
Publication title -
dermatology
Language(s) - English
Resource type - Journals
eISSN - 1421-9832
pISSN - 1018-8665
DOI - 10.1159/000246948
Subject(s) - pemphigus foliaceus , desmoglein 1 , paraneoplastic pemphigus , histopathology , pemphigus , pathology , direct fluorescent antibody , immunoglobulin d , autoantibody , immunofluorescence , gammopathy , immunology , immunoglobulin a , antibody , medicine , desmoglein , monoclonal antibody , monoclonal , immunoglobulin g , b cell
A case is reported of a 60-year-old woman with acantholytic vesiculopustular dermatosis and IgA-lambda monoclonal gammopathy. The histopathology of vesiculopustular lesions showed intraepidermal acantholytic and neutrophilic blisters. Direct immunofluorescence revealed intercellular (IC) IgD deposition with concurrent deposits of IgA and C3. Indirect immunofluorescence and immunoblotting studies revealed that the patient had circulating IgG and IgA anti-IC antibodies both of which recognized the 150-kD desmoglein that was pemphigus foliaceus antigen in a bovine desmosome preparation.