{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T03:37:22Z","timestamp":1773113842968,"version":"3.50.1"},"reference-count":15,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2017,11,8]],"date-time":"2017-11-08T00:00:00Z","timestamp":1510099200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cutan Pathol"],"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Direct immunofluorescence (DIF) panels (IgG, IgA, IgM, C3 and fibrinogen) are ordered for clinically suspected vasculitis, with frequently negative results.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cases submitted for DIF and histology (2010\u20102014) with \u201cvasculitis\u201d in the clinical data were examined, and the electronic medical record reviewed for clinical suspicion of Henoch\u2010Sch\u00f6nlein purpura (HSP). Peri\/intravascular IgA was considered positive, other reactants non\u2010specific and no immunoreactivity negative.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Vasculitis was the given indication for 20% (258\/1318) of DIF studies. HSP was clinically suspected in 36% (95\/258). In this setting, leukocytoclastic vasculitis (LCV) was common (66%, 63\/95) and DIF was positive in 43% (27\/63). One hundred percentage of DIF+ had LCV+. In cases without HSP suspicion, 26% (42\/163) were LCV+ and &lt;1% DIF+. Of the 258 cases, LCV+ greatly enriched for DIF+ (105\/258 LCV+ with 28\/105 [27%] DIF+), captured 100% of HSP and included cases with non\u2010specific DIF\/etiologic findings. In LCV cases, DIF positivity was not seen, HSP was not diagnosed and non\u2010specific DIF findings were common.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>LCV is an H&amp;E\u2010based histopathologic diagnosis that can have positive, negative and non\u2010specific DIF results that are rarely contributory except in the setting of HSP, where DIF is best utilized with IgA as the sole immunoreactant. H&amp;E\u2010based triage of DIF orders is recommended.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cup.13054","type":"journal-article","created":{"date-parts":[[2017,10,6]],"date-time":"2017-10-06T15:16:37Z","timestamp":1507302997000},"page":"16-22","source":"Crossref","is-referenced-by-count":14,"title":["Direct immunofluorescence testing in vasculitis\u2014A single institution experience with Henoch\u2010Sch\u00f6nlein purpura"],"prefix":"10.1111","volume":"45","author":[{"given":"Patrick","family":"Feasel","sequence":"first","affiliation":[{"name":"Departments of Pathology and Dermatology Cleveland Clinic Foundation  Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2278-5908","authenticated-orcid":false,"given":"Steven D.","family":"Billings","sequence":"additional","affiliation":[{"name":"Departments of Pathology and Dermatology Cleveland Clinic Foundation  Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wilma F.","family":"Bergfeld","sequence":"additional","affiliation":[{"name":"Departments of Pathology and Dermatology Cleveland Clinic Foundation  Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melissa P.","family":"Piliang","sequence":"additional","affiliation":[{"name":"Departments of Pathology and Dermatology Cleveland Clinic Foundation  Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anthony P.","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Departments of Pathology and Dermatology Cleveland Clinic Foundation  Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0629-775X","authenticated-orcid":false,"given":"Jennifer S.","family":"Ko","sequence":"additional","affiliation":[{"name":"Departments of Pathology and Dermatology Cleveland Clinic Foundation  Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,11,8]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.2165\/00128071-200809020-00001"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.dad.0000181109.54532.c5"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.dad.0000246646.45651.a2"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.37715"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/DAD.0000000000000122"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-4632.2004.01714.x"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000372-199906000-00005"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.det.2012.06.008"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1159\/000109589"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPMB1A9QSWUJDY"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2011.06.012"},{"issue":"1","key":"e_1_2_5_13_1","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1684\/ejd.2013.2243","article-title":"The correlation between cutaneous IgM deposition and renal involvement in adult patients with Henoch\u2010Schonlein purpura","volume":"24","author":"Belli AA","year":"2014","journal-title":"Eur J Dermatol"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2009.11.690"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2010.12.044"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOR.0000000000000346"}],"container-title":["Journal of Cutaneous Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fcup.13054","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/cup.13054","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T00:51:23Z","timestamp":1695516683000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/cup.13054"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,11,8]]},"references-count":15,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2018,1]]}},"alternative-id":["10.1111\/cup.13054"],"URL":"https:\/\/doi.org\/10.1111\/cup.13054","archive":["Portico"],"relation":{},"ISSN":["0303-6987","1600-0560"],"issn-type":[{"value":"0303-6987","type":"print"},{"value":"1600-0560","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,11,8]]}}}