Linear immunoglobulin A/immunoglobulin G bullous dermatosis associated with Vogt-Koyanagi-Harada disease

Abstract

Vogt-Koyanagi-Harada disease is characterized by marked bilateral uveitis associated with symmetric vitiligo, alopecia, poliosis and dysacousia. Linear immunoglobulin (Ig)A bullous dermatosis (LABD) is characterized by small, tense, subepidermal bullae caused by IgA type autoantibody targeting the basal lamina. LABD patients sometimes show coexistence of IgG type autoantibody, termed linear IgA/IgG bullous dermatosis (LAGBD). We reported a 35-year-old Japanese male case of combined LAGBD and Vogt-Koyanagi-Harada disease. His human leukocyte antigen typing was -A24, B52, C*1202, DR*1502, DQ*0601. Immunoblot revealed that patient sera reacted to both 180- and 230-kDa proteins at the IgA and IgG level. Because Vogt-Koyanagi-Harada disease and LABD are reported to be associated with other autoimmune diseases, it is probable that Vogt-Koyanagi-Harada disease and LAGBD in our case may be associated with each other in the pathomechanism. However, we cannot exclude the possibility of this being mere coincidence.

Linear immunoglobulin A/G bullous dermatosis associated with ulcerative colitis

“…Recently, immunoblot studies have indicated that LAGBD sera show circulating IgA and IgG antibodies reactive with various autoantigens: BP230, BP180 NC16a domain, 97/120‐kDa LAD‐1, BP180 C‐terminal domains, laminin‐332, 290‐kDa type‐VII collagen and 200‐kDa laminin‐γ1 . Our patient showed that IgG antibodies reacted with the BP180 NC16a domain and 120‐kDa LAD‐1 in immunoblotting analyses, and IgG antibodies to BP230 in ELISA.…”

“…They stated that direct IF of a lung biopsy specimen revealed deposition of IgA, IgG and C3 along the epithelial cell membrane and basement membrane of bronchioles and alveoli. Yanagihara et al . reported a case of concurrent LAGBD and VKHD.…”

“…Linear IgA/IgG bullous dermatosis is associated with systemic diseases such as malignant B-cell lymphoma, 2 Vogt-Koyanagi-Harada disease (VKHD) 3 and interstitial pneumonia. 9 This is the first report of LAGBD associated with UC, although the associations between other immunobullous skin diseases and UC have been reported.…”

“…They stated that direct IF of a lung biopsy specimen revealed deposition of IgA, IgG and C3 along the epithelial cell membrane and basement membrane of bronchioles and alveoli. Yanagihara et al 3 reported a case of concurrent LAGBD and VKHD. They stated that the onset of VKHD was earlier than that of LAGBD, and that the clinical time-course of both diseases was not correlated perfectly.…”

Linear immunoglobulin A/immunoglobulin G bullous dermatosis with autoantibodies to LAD-1 and laminin-γ1

“…To our knowledge, only seven patients with LAGBD with multiple autoantibodies have been reported previously (Table ) . Most of these cases showed reactivity with laminin‐332 and/or BP180.…”