Complement and Glomerular Disease – A Natural History Study

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Abstract
Over a 5 yr period, sequential measurements of a range of complement components (C) were performed in 127 patients. Each had a well-characterized glomerular lesion, there was no evidence of an underlying connective tissue disorder. In 17 patients with varied histopathology, who did not have C3 nephritic factor, there was a persisting C defect which was present during remission. The finding of such defects suggests that primary C system abnormalities predispose to the development of glomerular lesions. These abnormalities did not influence the prognosis of the patients. In 12 other cases without C3 nephritic factor, C levels were below the normal range when the glomerular lesion was active, but returned to it in remission; these were secondary changes. By discriminant analysis, some circulating C levels, assessed in relation to each other and without reference to a statistically derived normal range, discriminated between histological subgroups and had prognostic significance. These patterns could not be distinguished until the data were stored and analyzed by computer.

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