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Ocular Cicatricial Pemphigoid With Granular IgA and Complement Deposition

Ocular Cicatricial Pemphigoid With Granular IgA and Complement Deposition Abstract • A 65-year-old woman developed chronic redness of both eyes, and, over the ensuing 2½ years, she had progressive conjunctival scarring with symblepharon formation. Other mucosal surfaces were not involved. A conjunctival biopsy specimen 12 months following onset of her disease showed areas of epithelial separation from the basement membrane zone as well as subepithelial chronic inflammation and scarring. Two years later, another conjunctival biopsy specimen showed granular deposition of IgA and C3 along the epithelial basement membrane zone using direct immunofluorescent staining. Electron microscopy confirmed the presence of deposits that were morphologically consistent with antigen-antibody complexes. These findings suggest that antigen-antibody (IgA) immune-complex deposition may provide an alternative pathogenetic mechanism to basement membrane zone autoantibody formation for development of progressive conjunctival scarring. References 1. Bean SF: Cicatricial pemphigoid . Int J Dermatol 1975;14:23-26.Crossref 2. Person JR, Rogers RS: Bullous and cicatricial pemphigoid: Clinical, histopathologic, and immunopathologic correlations . Mayo Clin Proc 1977;52:54-66. 3. Bean SF, Rogers RS, Jordon RE, et al: Cicatricial pemphigoid , in Beutner EH, Chorzelski TP, Bean SF (eds): Immunopathology of the Skin , ed 2. New York, John Wiley & Sons Inc, 1979, pp 257-263. 4. Lever WF, Schaumburg-Lever G: Histopathology of the Skin , ed 6. Philadelphia, JB Lippincott Co, 1983, pp 117-118. 5. Bean SF, Waisman M, Michel B, et al: Cicatricial pemphigoid: Immunofluorescent studies . Arch Dermatol 1972;106:195-199.Crossref 6. Herron BE: Immunologic aspects of cicatricial pemphigoid . Am J Ophthalmol 1975;79:271-278. 7. Furey N, West C, Andrews T, et al: Immunofluorescent studies of ocular cicatricial pemphigoid . Am J Ophthalmol 1975;80:825-831. 8. Bean SF, Furey N, West CE, et al: Ocular cicatricial pemphigoid: Immunologic studies . Trans Am Acad Ophthalmol Otolaryngol 1976; 81:806-812. 9. Rogers RS, Perry HO, Bean SF, et al: Immunopathology of cicatricial pemphigoid: Studies of complement deposition . J Invest Dermatol 1977; 68:39-43.Crossref 10. Mondino BJ, Ross AN, Rabin BS, et al: Autoimmune phenomena in ocular cicatricial pemphigoid . Am J Ophthalmol 1977;83:443-450. 11. Anderson SR, Jensen OA, Kristensen EB, et al: Benign mucous membrane pemphigoid: III. Biopsy . Acta Ophthalmol 1974;52:455-463.Crossref 12. Mondino BJ, Brown SI: Ocular cicatricial pemphigoid . Ophthalmology 1981;88:95-100.Crossref 13. Lass JH, Thoft RA, Dohlman CH: Idoxuridine-induced conjunctival cicatrization . Arch Ophthalmol 1983;101:747-750.Crossref 14. Franklin RM, Fitzmorris CT: Antibodies against conjunctival basement membrane zone: Occurrence in cicatricial pemphigoid . Arch Ophthalmol 1983;101:1611-1613.Crossref 15. Harrist TJ, Mihm MC: Cutaneous immunopathology: The diagnostic use of direct and indirect immunofluorescence techniques in dermatologic disease . Hum Pathol 1979;6:625-653.Crossref 16. Anhalt GJ, Bahn CF, Labib RS, et al: Pathogenic effects of bullous pemphigoid autoantibodies on rabbit corneal epithelium . J Clin Invest 1981;68:1097-1101.Crossref 17. Sams WM Jr: Bullous pemphigoid: Is it an immunologic disease? Arch Dermatol 1970;102: 485-497.Crossref 18. Zone JL, LaSalle BA, Provost TT: Circulating immune complexes of IgA type in dermatitis herpetiformis . J Invest Dermatol 1980;75:152-155.Crossref 19. Gammon WR, Briggaman RA, Inman AO, et al: Evidence supporting a role for immune complex-mediated inflammation in the pathogenesis of bullous lesions of systemic lupus erythematosus . J Invest Dermatol 1983;81:320-325.Crossref 20. Wuepper KD, Watson PA, Kazmierowski JA: Immune complexes in erythema multiforme and the Stevens-Johnson syndrome . J Invest Dermatol 1980;74:368-371.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Ocular Cicatricial Pemphigoid With Granular IgA and Complement Deposition

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References (21)

Publisher
American Medical Association
Copyright
Copyright © 1985 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1985.01050110063026
Publisher site
See Article on Publisher Site

Abstract

Abstract • A 65-year-old woman developed chronic redness of both eyes, and, over the ensuing 2½ years, she had progressive conjunctival scarring with symblepharon formation. Other mucosal surfaces were not involved. A conjunctival biopsy specimen 12 months following onset of her disease showed areas of epithelial separation from the basement membrane zone as well as subepithelial chronic inflammation and scarring. Two years later, another conjunctival biopsy specimen showed granular deposition of IgA and C3 along the epithelial basement membrane zone using direct immunofluorescent staining. Electron microscopy confirmed the presence of deposits that were morphologically consistent with antigen-antibody complexes. These findings suggest that antigen-antibody (IgA) immune-complex deposition may provide an alternative pathogenetic mechanism to basement membrane zone autoantibody formation for development of progressive conjunctival scarring. References 1. Bean SF: Cicatricial pemphigoid . Int J Dermatol 1975;14:23-26.Crossref 2. Person JR, Rogers RS: Bullous and cicatricial pemphigoid: Clinical, histopathologic, and immunopathologic correlations . Mayo Clin Proc 1977;52:54-66. 3. Bean SF, Rogers RS, Jordon RE, et al: Cicatricial pemphigoid , in Beutner EH, Chorzelski TP, Bean SF (eds): Immunopathology of the Skin , ed 2. New York, John Wiley & Sons Inc, 1979, pp 257-263. 4. Lever WF, Schaumburg-Lever G: Histopathology of the Skin , ed 6. Philadelphia, JB Lippincott Co, 1983, pp 117-118. 5. Bean SF, Waisman M, Michel B, et al: Cicatricial pemphigoid: Immunofluorescent studies . Arch Dermatol 1972;106:195-199.Crossref 6. Herron BE: Immunologic aspects of cicatricial pemphigoid . Am J Ophthalmol 1975;79:271-278. 7. Furey N, West C, Andrews T, et al: Immunofluorescent studies of ocular cicatricial pemphigoid . Am J Ophthalmol 1975;80:825-831. 8. Bean SF, Furey N, West CE, et al: Ocular cicatricial pemphigoid: Immunologic studies . Trans Am Acad Ophthalmol Otolaryngol 1976; 81:806-812. 9. Rogers RS, Perry HO, Bean SF, et al: Immunopathology of cicatricial pemphigoid: Studies of complement deposition . J Invest Dermatol 1977; 68:39-43.Crossref 10. Mondino BJ, Ross AN, Rabin BS, et al: Autoimmune phenomena in ocular cicatricial pemphigoid . Am J Ophthalmol 1977;83:443-450. 11. Anderson SR, Jensen OA, Kristensen EB, et al: Benign mucous membrane pemphigoid: III. Biopsy . Acta Ophthalmol 1974;52:455-463.Crossref 12. Mondino BJ, Brown SI: Ocular cicatricial pemphigoid . Ophthalmology 1981;88:95-100.Crossref 13. Lass JH, Thoft RA, Dohlman CH: Idoxuridine-induced conjunctival cicatrization . Arch Ophthalmol 1983;101:747-750.Crossref 14. Franklin RM, Fitzmorris CT: Antibodies against conjunctival basement membrane zone: Occurrence in cicatricial pemphigoid . Arch Ophthalmol 1983;101:1611-1613.Crossref 15. Harrist TJ, Mihm MC: Cutaneous immunopathology: The diagnostic use of direct and indirect immunofluorescence techniques in dermatologic disease . Hum Pathol 1979;6:625-653.Crossref 16. Anhalt GJ, Bahn CF, Labib RS, et al: Pathogenic effects of bullous pemphigoid autoantibodies on rabbit corneal epithelium . J Clin Invest 1981;68:1097-1101.Crossref 17. Sams WM Jr: Bullous pemphigoid: Is it an immunologic disease? Arch Dermatol 1970;102: 485-497.Crossref 18. Zone JL, LaSalle BA, Provost TT: Circulating immune complexes of IgA type in dermatitis herpetiformis . J Invest Dermatol 1980;75:152-155.Crossref 19. Gammon WR, Briggaman RA, Inman AO, et al: Evidence supporting a role for immune complex-mediated inflammation in the pathogenesis of bullous lesions of systemic lupus erythematosus . J Invest Dermatol 1983;81:320-325.Crossref 20. Wuepper KD, Watson PA, Kazmierowski JA: Immune complexes in erythema multiforme and the Stevens-Johnson syndrome . J Invest Dermatol 1980;74:368-371.Crossref

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Nov 1, 1985

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