Yonsei Med J.  2003 Feb;44(1):75-80. 10.3349/ymj.2003.44.1.75.

Glomerular C4d Deposition Indicates in situ Classic Complement Pathway Activation, but is not a Marker for Lupus Nephritis Activity

• Kim SH
• Jeong HJ

• KMID: 1719072
• DOI: http://doi.org/10.3349/ymj.2003.44.1.75

Abstract

This study was designed to evaluate whether glomerular C4d deposition may be a useful marker of lupus nephritis activity. Twenty-one patients diagnosed as having lupus nephritis (WHO class III: 4 cases; IV: 12 cases; V: 5 cases) were included. Mean patient age was 29.3 +/- 13.5 years (range: 7-55 years). The presence and intensity of glomerular C4d deposition were compared with the corresponding histologic activity index for each case. Immunofluorescence for C4d showed diffusely granular staining along glomerular capillary loops, in all cases examined (1+, in 8 cases; 2+, in 7 cases; 3+, in 6cases). In eight cases, C4d deposition was found in the absence of capillary or mesangial C4 deposits. Moreover, the intensity of C4d deposits correlated with those of capillary IgG, IgA, C4, C1q, and fibrinogen deposits. However, C4d staining intensity did not correlate with the lupus nephritis activity index. Although glomerular capillary C4d deposition is a sensitive marker of classic complement pathway activation, it is not a sensitive marker for active lupus nephritis.

Keyword

Lupus nephritis; C4d; activity index (AI)

MeSH Terms

Adolescent
Adult
Biological Markers
Child
Complement 4/*metabolism
Complement Pathway, Classical/*physiology
Female
Human
Kidney Glomerulus/*metabolism
Lupus Nephritis/*physiopathology
Male
Middle Aged
Peptide Fragments/*metabolism
Severity of Illness Index