SLEの臨床ならびに血清学的所見と皮膚,腎の免疫病理学的関係について

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  • A Study of Correlation Between Clinicopathological Findings and Immunopathological Findings of Skin and Kidney with SLE
  • SLE ノ リンショウ ナラビニ ケッセイガクテキ ショケン ト ヒフ ジン

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Thirty one cases with SLE and 70 cases with various renal diseases such as IgA nephropathy: 40, membranous nephropathy : 5, lipoid nephrosis : 4, acute glomerulonephritis : 5, Schonlein-Henoch purpura: 2 and the other : 14 were performed skin and renal biopsy for the immunopathological study. The skin specimens were obtained from involved and uninvolved area in the cases of SLE and from the arm in the cases of the other renal diseases. Immunofluorescent study revealed granular deposition of IgG and/or Clq alone dermal-epidermal junction (DEJ), which are seen in 95% in involved skin and in 41% in uninvolved skin of the cases with SLE. But none of the cases with the other renal diseases showed IgG and/or Clq along DEJ. As the IC. deposits in DEJ of involved skin were seen in the majority cases with SLE, we are interested in studying, whether the presence of IgG and/or Clq in the uninvolved skin is significant for the evaluation of clinico-serological and renal findings. The evaluation of positive (+) and negative (-) lupus band test (LBT) was as follows; regarding with the duration of the diseases : 1.9 years in LBT (+) and 6.1 years in LBT (-), the amount of C4: 13.9 mg/dl and 17.9 mg/dl, the amount of immune complexes : rather low and high and the existence of glomerular morphological changes : 100% and 83%. Regarding with the correlation between LBT and renal findings, 3 cases with minimal glomerular changes were LBT (-), the cases with both IgG and Clq along DEJ showed mainly mesangial deposits of Ig and complement, whereas the cases with only IgG along DEJ membranous nephropathy. There were no correlation between LBT (+) and the other findings such as dermatological findings (butterfly rash et al), the levels of CH50, C3 and Clq, the titer of ANF, anti-DNA antibody and the number of T and B Lymphocytes. Those evidences suggested that skin biopsy from involved and univolved area is significant for diagnosis of SLE and for the evaluation of clinical activity of SLE and of the underlying lupus nephritis.

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