Extraglomerular immune complex deposition in lupus nephritis

Lupus ◽  
2021 ◽  
pp. 096120332110625
Author(s):  
Valentina Papa ◽  
James Brainer ◽  
Kammi J Henriksen ◽  
Giovanna Cenacchi ◽  
Anthony Chang
Keyword(s):  
Electron Microscopy ◽  
Systemic Lupus Erythematosus ◽  
Retrospective Study ◽  
Lupus Nephritis ◽  
Immune Complex ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Immune Complex Deposition ◽  
Complex Deposition ◽  
Common Manifestation

Background Lupus nephritis (LN) is a common manifestation and a major cause of morbidity and mortality in systemic lupus erythematosus (SLE) patients. It is characterized by glomerular and often extraglomerular immune complex deposition. Purpose Given the emerging importance of the tubulointerstitial compartment, we conducted a retrospective study of 78 LN biopsies to enumerate the spectrum of extraglomerular immune complex deposition that can be observed in lupus nephritis by electron microscopy and to identify possible clinical or pathologic correlates. Results The presence of tubulointerstitial immune complex deposition often accompanied interstitial inflammation, but some discrepancies were also seen. Conclusions As target antigens are identified, correlation with glomerular, tubulointerstitial, and vascular immune complex deposition will be of increasing interest.

Polyneuropathy with endoneurial immune complex deposition as the first manifestation of systemic lupus erythematosus

1998 ◽  
Vol 96 (3) ◽  
pp. 297-300 ◽  
Author(s):  
I. Bódi ◽  
P. Váradi ◽  
G. Pokorny ◽  
J. Engelhardt ◽  
G. Dibó ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Immune Complex ◽  
Lupus Erythematosus ◽  
Systemic Lupus ◽  
Immune Complex Deposition ◽  
Complex Deposition

Alveolar Hemorrhage and Renal Microangiopathy in Systemic Lupus Erythematosus

2001 ◽  
Vol 125 (4) ◽  
pp. 475-483 ◽  
Author(s):  
Michael D. Hughson ◽  
Zhi He ◽  
Jeffrey Henegar ◽  
Robert McMurray
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Immune Complex ◽  
Lupus Erythematosus ◽  
Alveolar Hemorrhage ◽  
Alveolar Wall ◽  
Systemic Lupus ◽  
Immune Complex Deposition ◽  
Complex Deposition ◽  
Lung And Kidney ◽  
Renal Lupus

Abstract Context.—Acute alveolar hemorrhage in systemic lupus erythematosus usually occurs as a pulmonary-renal syndrome. In most cases, the lungs show “bland” alveolar hemorrhage with little or no inflammation. Whether this alveolar injury is similar to the better-defined noninflammatory renal lupus vasculopathy is unresolved. Objectives.—To investigate the relationships and the mechanisms of small vascular injury in the lung and kidney of 2 lupus patients who died of diffuse AH. Methods.—We investigated the relationship of AH to immune complex deposition in the lungs of 6 patients with systemic lupus erythematosus and correlated the findings with glomerular and vascular disease in the kidney. Lung and kidney were studied by light, immunofluorescence, and/or electron microscopy; apoptosis was investigated using in situ nick-end labeling. Results.—The clinical course of 2 patients was complicated by alveolar hemorrhage, and the lungs of these patients revealed alveolar wall immune complex deposits and bland alveolar hemorrhage. These 2 patients had World Health Organization class IV lupus nephritis and renal arterioles involved by a noninflammatory lupus vasculopathy. Apoptosis was identified in the lupus microangiopathy and in alveolar walls within areas of alveolar hemorrhage. Alveolar wall immune complex deposits were not found in 4 patients who had a lupus glomerulonephritis but did not have renal lupus vasculopathy. Apoptosis was not seen in renal arterioles or lungs of these 4 cases, except in areas of diffuse alveolar damage or herpesvirus pneumonia. Conclusions.—Our findings indicate that alveolar hemorrhage in systemic lupus erythematosus, characterized by bland alveolar wall changes, is pathogenetically similar to the lupus microangiopathy of the kidney. In both lung and kidney, the pathogenesis of the microvascular injury appears to be related to immune complex deposition and the induction of apoptosis.

Maternal and Fetal Outcomes in Iranian Patients with Systemic Lupus Erythematosus: A Five-Year Retrospective Study of 60 Pregnancies

2019 ◽  
Vol 15 (4) ◽  
pp. 321-328
Author(s):  
P. Karimzadeh ◽  
S. Shenavandeh ◽  
N. Asadi
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Retrospective Study ◽  
Lupus Nephritis ◽  
Lupus Erythematosus ◽  
Medical Science ◽  
Reproductive Age ◽  
Long Term Results ◽  
Maternal Outcomes ◽  
Systemic Lupus ◽  
Fetal Outcomes

Background: As a multisystem autoimmune disease, Systemic Lupus Erythematosus (SLE) mainly affects women during reproductive age. This retrospective study was designed to investigate the fetal and maternal outcomes of Iranian women with SLE. Methods: Clinical and laboratory records of 60 pregnancies in 55 SLE patients who attended Hafez hospital, a tertiary referral center for high risk pregnancies and SLE patients affiliated with Shiraz University of Medical Science, were reviewed during April 2012 and March 2016. Results: The mean age of the patients was 29.28±4.6 years and mean disease duration was 5.09±4.2 years. Live birth rate was 83.3% after exclusion of elective abortions. There were 50 live births, 3 neonatal deaths, 3 spontaneous abortions and 7 stillbirths. 9 (15%) women developed preeclampsia and there was 1 (1.6%) case of HELLP syndrome. Lupus flares occurred in 27 (45%) patients during pregnancy. Preterm delivery occurred in 11.6% of pregnancies. Skin and joints were the most frequently affected organs. Patients with previous lupus nephritis (n=18) were associated with a higher risk of maternal complication, but fetal outcomes were similar in both groups. Cesarean rate was about 66%, mostly related to fetal indications (50%). Conclusion: Pregnancies in most women with pre-existing SLE can now be managed with successful results although presence of previous lupus nephritis is still a major risk factor for adverse maternal outcomes. In our study, fetal outcome was not different between patients with lupus nephritis compared with the patients without nephritis who were under treatments. Hence, to achieve favorable long-term results, we recommend regular multispecialty treatment approaches and progestational counseling for women with SLE.

Nephritis in Children and Young Adults with Systemic Lupus Erythematosus and Normal Urinary Sediment

PEDIATRICS ◽  
1979 ◽  
Vol 64 (5) ◽  
pp. 678-685
Author(s):  
Alan Woolf ◽  
Byron Croker ◽  
Stephen G. Osofsky ◽  
Deborah W. Kredich
Keyword(s):  
Electron Microscopy ◽  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Fluorescent Antibody ◽  
Renal Involvement ◽  
Systemic Lupus ◽  
Biochemical Tests ◽  
Complex Deposition ◽  
Diffuse Proliferative Glomerulonephritis ◽  
Antibody Levels

One male and seven female patients (aged 6 to 26 years) with systemic lupus erythematosus (SLE), normal urinalyses, and normal biochemical tests of renal function, had renal biopsies to determine if significant nephropathy existed. Several had active SLE in other body systems at the time, either clinically or as evidenced by low serum complement and high native DNA antibody levels. The renal biopsy specimens were studied by light, fluorescent antibody, and electron microscopy. Three patients had a generalized segmental, two had a focal segmental, and one had a generalized diffuse proliferative glomerulonephritis. In addition, one patient had minimal glomerular findings with interstitial inflammation. All eight patients were found to have moderate immune complex deposition by immunofluorescence and/or electron microscopy studies. The absence of clinical renal involvement in patients with SLE does not preclude ongoing active and "silent" glomerular damage with moderately severe proliferative changes.

Sign in / Sign up

Export Citation Format

Share Document