Author/Editor     Ferluga, Dušan; Hvala, Asta; Vizjak, Alenka
Title     Imunski depoziti in histopatologija vnetnega odziva pri sistemskem lupusu eritematozusu
Translated title     Immune deposits and histopathology of inflammatory reaction in systemic lupus erythematosus
Type     članek
Source     Med Razgl
Vol. and No.     Letnik 38, št. Suppl 7
Publication year     1999
Volume     str. 45-53
Language     slo
Abstract     A review of hypotheses on the etiopathogenesis of systemic lupus erythematosus (SLE) is presented in the introduction of this paper. Our study explored the relationship between glomerular immune deposits and local inflammatory reaction by light, immunofluorescence and electron microscopic methods on 333 biopsy and 37 autopsy kidney samples of 267 SLE patients. Glomerular immune deposits were found to be present in 99% of patients. The prevalence of immune deposits in other parts of the nephron, as well as in other organs, was significantly lower. A full-house pattern by immunofluorescence and mesangial-transmembranous distribution of immune deposits were confirmed as characteristic for SLE. Histomorphologically, a characteristic mixed mebranous and proliferative pattern of inflammatory reaction was found in one third of SLE patients, while patterns chaacterizing various forms of isolated glomerulonephritis, were observed in others. The diagnostic and prognostic significance of the glomerular immune deposit distribution pattern as well as its correlation with the inflammatory reaction and WHO classes of lupus glomerulonephritis were revealed. There was often no correlation found between immune deposits and inflammatory reaction in other organs, which will be the subject of our future investigation.
Summary     V uvodnem delu članka so pregledno predstavljene hipoteze o etiopatogenezi sistemskega lupusa eritematozusa (SLE). V naši študiji smo s svetlobno, imunofluorescenčno in elektronsko mikroskopskimi metodami raziskali odnose med glomerulnimi imunskimi depoziti in lokalno vnetno reakcijo na 333 biopsijskih in 37 avtopsijskih vzorcih ledvic 267 bolnikov s SLE. Ugotovili smo navzočnosti imunskih depozitov v glomerulih pri 99% bolnikov. Pogostnost imunskih depozitov v drugih delih nefrona in v drugih organih je bila bistveno manjša. Imunofluorescenčno mikroskopski "full-house" vzorec in mezangijsko-transmembranski distribucijski vzorec glomerulnih imunskih depozitov sta bila potrjena kot značilnost SLE. Ugotovili smo histomorfološke vzorce glomerulne vnetne reakcije, ki opredeljujejo različne oblike samostojnega glomerulonefritisa, pri eni tretjini bolnikov s SLE pa značilen mešani membranski in proliferacijski vzorec. Dokazan je bil diagnostični in prognostični pomen distribucijskega vzorca glomerulnih imunskih depozitov, kakor tudi njegova korelacija s histomorfološkimi vzorci vnetne reakcije in WHO-razredi lupusnega glomerulonefritisa. Pogosta odsotnost korelacije med imunskimi depoziti in vnetno reakcijo v drugih organih bo tema prihodnjih raziskav.
Descriptors     LUPUS ERYTHEMATOSUS, SYSTEMIC
IMMUNE COMPLEX DISEASES
LUPUS NEPHRITIS
ANTIGEN-ANTIBODY COMPLEX