Posters

Biopsy in mucous membrane pemphigoid patients: which location should you sample?

Poster Details

First Author: G.Coco UK

Co Author(s):    D. Borroni   N. Menassa   K. Iselin   S. Kaye   V. Romano        

Abstract Details

Purpose:

To analyse direct immunofluorescence results of the conjunctival biopsy in mucous membrane pemphigoid (MMP) patients in relation to ocular surface location.

Setting:

Department of Ophthalmology, St. Paul’s Eye Unit, Royal Liverpool University Hospital, Liverpool, United Kingdom

Methods:

Retrospective analysis of all MMP patients who underwent conjunctival biopsy from March 2014 to February 2019. Direct immunofluorescence analysis was performed at Saint John’s Institute of Dermatology in London, the results were labelled as “positive”, when deposition of at least one among IgM, IgG, IgA, and C3 was found at the basement membrane of the specimen, “non-specific” when only fibrinogen was found and “negative” when none of the above features was present.

Results:

Forty-one patients records were analysed.  Mean age was 74±12.1 years (66% females). Nine patients were excluded because of either no information on biopsy location or no epithelium present. A total of 32 patients were analysed. Lesional specimens resulted positive in 20% of cases (1/6), and non-specific or negative in 80% (5/6), peri-lesional specimens were 75% positive (6/8),  and 25% non-specific or negative (2/8), specimens from bulbar conjunctiva were 50% positive (5/10) and 50% non-specific or negative (5/10), specimens from forniceal/palpebral conjunctiva were 18% positive (3/17), and 82% non-specific or negative (14/17) (p = 0.023).

Conclusions:

Conjunctival biopsies collected from peri-lesional areas show a higher rate of detection of the presence of IgM, IgG, IgA, and C3 deposits at the epithelium basement membrane to confirm the diagnosis of MMP.

Financial Disclosure:

None