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The Contribution of Immunopathology to the Diagnosis and Classification of Systemic Lupus Erythematosus: Relationship between Serum Anti‐DNA, Complement and Renal Biopsy Changes

Summary: The contribution of immunopathology to the diagnosis and classification of systemic lupus erythematosus: Relationship between serum anti-DNA, complement and renal biopsy changes. R. J. Rigby, R. L. Dawkins, P. H. Kay, L R. Matz, J. M. Papadimitriou, J. Quintner and E. F. Haywood, Aust. N.Z. J. Med., 1978, 8, pp. 29–38. 
 
 
 
Twenty-three patients with systemic lupus erythematosus (SLE) were studied in an attempt to define diagnostic laboratory criteria and those features which discriminate between mild and severe renal involvement. Although there was generally a relationship between serum C3 and C4 concentrations, the latter was more commonly below the normal range. An elevated serum anti-DNA was common and generally associated with a low C4. Renal involvement as indicated by positive glomerular immunofluorescence was almost invariable. Most cases showed mild mesangio-pro/iferative change, patchy granular immunofluorescence and electron dense deposits predominantly within the mesangium. Those cases with more severe renal involvement were distinguished by a high anti-DNA and a very low C3, as well as proteinuria and diffuse sub-endothelial deposits as indicated by the combination of immunofluorescence and electron microscopy. These results suggest that glomerular immunofluorescence and the combination of serum anti-DNA and C4 are helpful diagnostic criteria.