IMMUNOPATHOLOGY OF EARLY AND CLINICALLY SILENT LUPUS NEPHROPATHY

  • 1 January 1977
    • journal article
    • research article
    • Vol. 87  (1) , 1-18
Abstract
Detailed immunopathologic studies of early or silent renal alterations in systemic lupus erythematosus are 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 EM. 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 yr. The significance of these findings is discussed in relation to the spectrum of clinical and immunopathologic alterations in lupus nephritis and transformation of the original disease.