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We appreciate the comments of Foureur et al regarding possible associations between BP and neurologic diseases. We also debated whether the false-positive cases in our study could have potential clinical significance and agree that patients testing positive for anti-BP antibodies without clinical evidence of BP should be further studied for relevant clinical disease associations.
Our article commented specifically on the cutaneous and autoimmune medical histories; however, the initial chart review included all major clinical diagnoses from the subjects who tested positive. Five of the 25 patients who tested positive had neurologic diseases listed in the medical record, including migraines (a 25-year-old woman), narcolepsy (a 46-year-old man), Lewy body dementia (a 68-year-old man and a 93-year-old man), and Alzheimer dementia (an 86-year-old woman). The positive cases with dementia were all diagnosed in conjunction with neurology consultation, and the 2 younger subjects with dementia also underwent formal neuropsychometric testing. We agree with Foureur et al that the link between anti-BP antibodies and neurologic diseases is an important clinical question, and as a result, we intend to study the potential clinical significance of anti-BP antibodies.
Wieland CN, Comfere NI, Gibson LE, Weaver AL, Krause PK, Murray JA. Value of the Detection of Circulating Antibodies Against BP Antigens in Unaffected Subjects—Reply. Arch Dermatol. 2010;146(7):802. doi:10.1001/archdermatol.2010.148