Diagnosis of lupus nephritis by skin immunofluorescence, in the absence of extrarenal manifestations of systemic lupus erythematosus.
Six patients with glomerulonephritis were found to have granular deposits of complement and/or immunoglobulins at the dermalepidermal junction of normal skin. No patient had extrarenal clinical manifestations of systemic lupus erythematosus (SLE). The only serologic test suggestive of SLE was a positive antinuclear antibody (ANA) reaction; results of complement and antinative deoxyribonucleic acid (DNA)-antibody tests were repeatedly normal. The patients with glomerulonephritis had a favorable initial response to therapy with prednisone with or without azathioprine. These patients may represent a variant of SLE in which the diagnosis can only be established by a direct immunofluorescence test of normal skin. Alternatively, they may constitute a separate new clinical entity. Because of the favorable response to therapy, we suggest that skin immunofluorescence be performed in patients who present with unexplained glomerulonephritis and a positive ANA.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000974:Antibodies, Antinuclear; D005260:Female; D005455:Fluorescent Antibody Technique; D005921:Glomerulonephritis / Q000175:diagnosis / Q000209:etiology / Q000276:immunology*; D006801:Humans; D007136:Immunoglobulins; D007678:Kidney Glomerulus / Q000473:pathology; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000175:diagnosis / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D012867:Skin / Q000276:immunology
D000974:Antibodies, Antinuclear; D007136:Immunoglobulins