title: Immunopathology of early and clinically silent lupus nephropathy.
abstract: Detailed immunopathologic studies of early or silent renal alterations in systemic lupus erythematosus have been 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 electron microscopy. 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 years. The significance of these findings is discussed in relation to a) the spectrum of clinical and immunopathologic alterations in lupus nephritis and b) transformation of the original disease.
mesh_terms: D000293:Adolescent; D000328:Adult; D001485:Basement Membrane / Q000276:immunology; D003165:Complement System Proteins; D005260:Female; D005337:Fibrin; D005455:Fluorescent Antibody Technique; D005921:Glomerulonephritis / Q000209:etiology / Q000276:immunology / Q000473:pathology; D006801:Humans; D007136:Immunoglobulins; D007668:Kidney / Q000503:physiopathology; D007678:Kidney Glomerulus / Q000276:immunology / Q000473:pathology*; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000276:immunology / Q000473:pathology*; D008297:Male; D008875:Middle Aged
chemical_list: D007136:Immunoglobulins; D005337:Fibrin; D003165:Complement System Proteins