Immunopathology of early and clinically silent lupus nephropathy

Am J Pathol. 1977 Apr;87(1):1-18.

Abstract

Detailed immunopathologic studies of early or silent renal alterations in systemic lupus erythematosus have been sparse. The renal biopsies of 16 lupus patients with normal renal function, including 8 with hematuria and/or proteinuria of recent onset, and 8 without clinically detectable renal disease were investigated by light, immunofluorescence, and electron microscopy. Immunoglobulins, complement components, and electron-dense deposits were detected in glomeruli of all patients, regardless of morphologic appearance or lack of clinical evidence of renal involvement. Features of membranous glomerulonepritis were observed in 4 patients with substantial proteinuria. In the remaining 12 patients, including 3 with hematuria and 4 with slight proteinuria, either minimal glomerular alterations or features of mesangial proliferative glomerulonephritis were seen. Transformation of the original disease was demonstrated in 3 of 3 patients rebiopsied within 2 years. The significance of these findings is discussed in relation to a) the spectrum of clinical and immunopathologic alterations in lupus nephritis and b) transformation of the original disease.

MeSH terms

  • Adolescent
  • Adult
  • Basement Membrane / immunology
  • Complement System Proteins
  • Female
  • Fibrin
  • Fluorescent Antibody Technique
  • Glomerulonephritis / etiology
  • Glomerulonephritis / immunology
  • Glomerulonephritis / pathology
  • Humans
  • Immunoglobulins
  • Kidney / physiopathology
  • Kidney Glomerulus / immunology
  • Kidney Glomerulus / pathology*
  • Lupus Erythematosus, Systemic / complications
  • Lupus Erythematosus, Systemic / immunology
  • Lupus Erythematosus, Systemic / pathology*
  • Male
  • Middle Aged

Substances

  • Immunoglobulins
  • Fibrin
  • Complement System Proteins