Variable patterns of immunoglobulin and complement deposition in the kidneys of patients with systemic lupus erythematosus.
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Biomedical subjects
Publications and source records attributed to V Agnello.
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Two patients with hereditary homozygous C2 deficiency are described. They showed many similar clinical features. Both had discoid-like skin rashes and serologic abnormalities consistent with SLE, but neither had evidence of involvement of any organ other than skin. Although biopsy of these lesions revealed expected changes by light microscopy, typical immunofluorescent findings were not present. The presence of the HL-A haplotype 10, W18 was seen in both families and was associated with the C2 deficiency gene. The 2 patients were mutually nonreactive in MLC tests and both were found to be homozygous for the LD7a type.
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OBJECTIVE: To determine the prevalence of monoclonal rheumatoid factors (mRF) bearing the WA cross-idiotype (WA XId) in hepatitis C virus (HCV) positive type II mixed cryoglobulins, to review recent studies on the role of HCV in the cutaneous vasculitis lesions in patients with type II cryoglobulinemia and to discuss the implication of these studies for the etiopathogenesis and therapy of the disease. METHODS: Thirty type II cryoglobulins were tested for WA and PO XId and for HCV RNA: RESULTS: WA mRF were strongly, although not exclusively, associated with HCV in type II mixed cryoglobulinemia. CONCLUSION: These and other recent studies from our laboratory suggest that chronic HCV infection may be the stimulus for the production of WA mRF and that HCV may be directly involved in the pathogenesis of the cutaneous vasculitis in patients with type II cryoglobulinemia. The association of HCV infection with the disease provides a rationale for anti-viral therapy and for monitoring therapy by measuring the HCV level in both blood and liver.