(P2) Dis of Imm: Lupus nephritis (357)

Question 1

• name this slide*
• 1. Looking at the upper right Glomeruli-*

name and define the cells inside

Answer 1

Lupus nephritis

Mesangial cells are specialised cells in the kidney that make up the mesangium of the glomerulus.

-Mesangial cells can contract and relax to regulate capillary flow. This is regulated by vasoactive substances.

They are specialized smooth muscle cells that function to regulate blood flow through the capillaries.

Usually divided in to 2 types, each having a very distinct function and location. Extraglomerular & intraglomerular mesangial cells

Question 2

Lupus nephritis

Inside the Glomeruli, the MESENGLIAL CELLS are undergoing what type of action?

Answer 2

Diffuse or Focal proliferation

of

mesangial cells

in glomeruli

Question 3

Lupus Nephritis

• Describe the histological*
• characteristics:*

Answer 3

• 1. Narrow lumen of capillaries within the glomeruli*
• 2. Proliferation of cells (hypercellular pattern)*
• 3. Delicate, homogenous thickening of capillary wall (wire-loop lesion) Sub-endothelial deposits*
• 4. Wire-loop leasion (thickening of capillary)*
• 5. Subendothelial deposits (between endothelium and basement memebrane) of immune complexes*
• 6. Thickened, hyalinized loops of capillaries*
• 7. Usually in class IV (also in III and V)*
• 8. Indicates active disease*

Question 4

Lupus nephritis

1. What disease is this commonly associated with?
2. What parts of the body does it affect?

Answer 4

1. SLE (Systemic Lupus Erythematosus)

2. kidneys,

joints,

serious membrane,

skin

Question 5

Name 2 diagnostic markers of

Lupus nephritis

Answer 5

• 1. Smith antigen – soluble nuclear antigen complex that is part of spliceosome*
• 2. Antibody to double stranded DNA*

Question 6

What type of cells are proliferated in Lupus nephritis

and

what deposits are present?

Answer 6

Mesangial cells proliferate

and

deposits of IgG, IgM, IgE, IgC

Question 7

systemic lupus erythematosus

S/S

Name all that apply

Answer 7

Symptoms

• Butterfly rash, pleural effusion, heart problems, lupus nephritis, arthritis, Raynaud’s phenomenon
• Normal (only biochemical changes) no visible morphological change

Mesangial – proliferation of mesangium, mesangial matrix, deposits of IgG, IgM, IgE

and C

Question 8

5 patterns of SLE glomerular injury

Answer 8

1. Minimal or none (rare)

2. Mesangial lupus glomerulonephritis

a. Mesangial proliferation
b. Mesangial matrix, deposits of IgG, IgM, IgE and Complement

3. Focal proliferative glomerulonephritis

a. Only portions of each glomerulus affected

4. Diffuse proliferative glomerulonephritis

a. Proliferation of endothelial, mesangial, sometimes epithelia cells
b. Most serious. All glomeruli affected

5. Membranous glomerulonephritis

a. Widespread thickening of capillary walls

Question 9

Raynaud’s phenomenon

define:

Answer 9

Raynaud’s phenomenon is a condition that can cause discomfort as the blood supply to your extremities becomes reduced.

In general, fingers and toes are affected, but other parts of your body such as your nose, lips and ears can be affected too.

Question 10

SLE

Define:

Answer 10

systemic lupus erythematosus

is the most common type of lupus.

SLE is an autoimmune disease in which the immune system attacks its own tissues, causing widespread inflammation and tissue damage in the affected organs

Question 11

Systemic lupus erythematosus (SLE)

• Is conidered what type of disease:*
• Can affect what body parts:*

Answer 11

• “Systemic Autoimmune Disease”*
• It can affect the joints, skin, brain, lungs, kidneys, and blood vessels,*
• There is no cure for lupus*