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The distribution and character of glomerular deposits in systemic lupus erythematosus

1972; Elsevier BV; Volume: 2; Issue: 1 Linguagem: Inglês

10.1038/ki.1972.67

1523-1755

Isabel Dujovne, Victor E. Pollak, Conrad L. Pirani, Martin G. Dillard,

Vasculitis and related conditions

The distribution and character of glomerular deposits in systemic lupus erythematosus. Forty renal biopsy specimens from 24 patients with systemic lupus erythematosus were examined in detail to assess the amount, character, and distribution of deposits in the glomeruli. Semiquantitative electron microscopic and immunohistologic methods were used. The results were correlated with clinical and histological findings. Deposits were not randomly distributed. Rather, there was some relationship between increasing amounts of subendothelial and mesangial deposits. Subendothelial deposits were found only in active disease and were extensive only in the presence of extensive mesangial deposits. Contrary to expectation, there was an inverse relationship between the extent of subendothelial and subepithelial deposits. Extensive subendothelial deposits were found only with the most active histological changes and three of four patients with extensive subendothelial deposits died within weeks. Subendothelial deposits contained a wide variety of plasma proteins including, not only the immune globulins and β 1 C globulin, but also fibrinogen, albumin, and transferrin. In general, the clinical course of patients with extensive subepithelial deposits and intramembranous deposits was benign. Subepithelial deposits were found to contain only immune globulins and β 1 C globulin. Serial studies revealed the long term persistence of subepithelial deposits. By contrast, in patients who survived, subendothelial deposits disappeared with time and treatment.