A patient with pemphigus vulgaris involving oral mucosa and skin is started on therapy. Serial monitoring of which parameter best correlates with clinical disease activity and helps predict relapse?
- A Anti-desmoglein 1 ELISA titre
- B Serum total IgE level
- C Anti-desmoglein 3 ELISA titre ✓
- D Serum complement C3 level
Correct answer: C. Anti-desmoglein 3 ELISA titre
Explanation
In mucosal pemphigus vulgaris, anti-desmoglein 3 antibody levels measured by ELISA parallel clinical activity, and rising titres precede relapse, allowing preemptive therapy adjustment. Desmoglein 3 dominates in mucosal-type disease while desmoglein 1 antibodies correlate with cutaneous involvement, so anti-Dsg1 alone misses the mucosal component in most patients. Neither IgE nor B3 has any validated role in monitoring pemphigus activity. This serologic correlation is unique among immunobullous disorders.
Reference: Bolognia, Dermatology, 5th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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