Immunoglobulin in Clinically Uninvolved Skin in Systemic Lupus Erythematosus ASSOCIATION WITH RENAL DISEASE

Abstract

[LBT]). In patients with low serum complement levels, 91% had a positive LBT), as compared with 15% in those with normal complement levels. The LBT was positive in 70% of patients with clinical and laboratory evidence of renal disease, but in only 31% of patients without renal disease. 81% of patients with the more severe histologic forms of lupus nephritis, i.e., proliferative glomerulonephritis and membranous glomerulonephritis, had positive tests, whereas only 23% with mesangial glomerulitis or normal histologic findings were positive. Immunoglobulins of the same class found in the skin were detected in the glomeruli of patients examined by renal biopsy. These results suggest that there is a relationship between the occurrence of immunoglobulin in the epidermal basement membrane and the presence of the more severe forms of lupus nephritis.

Clinical significance of serum properdin levels and properdin deposition in the dermal-epidermal junction in systemic lupus erythematosus.

“…Others have correlated a positive lupus band test with disease activity (21,22,24) and we now document an association between deposition of a specific protein and disease activity. Our data revealed that IgA was absent in all nonlesional skin from patients with no evidence of clinical disease activity, while it was present in 7 of 23 with active disease.…”

“…Similar deposits have been described in the dermalepidermal junction (DEJ) of normal and lesional skin of SLE patients (18)(19)(20)(21). Several authors have correlated the presence in normal skin of immunoglobulins and complement (the "lupus band test") with lupus nephritis (21,22). Others have found no such correlation (23,24).…”

“…Properdin was detected by means of the indirect immunofluorescent technique (22), using the same rabbit antiproperdin employed in the properdin assay and FITC conjugated goat antirabbit IgG (Microbiological Associates, Bethesda, Md. ), F/P ratio 1.4.…”

Immunoglobulin classes of DNA binding activity in serum and skin in systemic lupus erythematosus.

“…3-mm punch biopsies were obtained from the light protected uninvolved skin of the medial surface of the volar forearm. Processing of the tissue and immunofluorescent tests were carried out as previously described (11).…”

Studies of repeat skin biopsies of nonlesional skin in patients with systemic lupus erythematosus

“…However, some other researchers did not reach this conclusion (8)(9)(10)(11)(12). We and some investigators also noted a correlation between serologic evidence of disease activity and the dermal-epidermal junction deposits (1)(2)(3)(4)(5)6,8,13), but this was not found by others (9,11,12). The relationship of such deposits to the presence of renal disease also has Seen disputed To clarify the relationship between clinical disease activity, renal disease, and serologic abnormalities, we studied a group of patients with systemic lupus erythematosus at 2 points in the course of their disease.…”