Clinical Pathology with Immune Complexes

Term lupus is wording by Rogerius in the 13th century to describe erosive facial lesions reminiscent of wolf’s bite. 1870 Kaposi distinguishes local discoid from disseminated lupus featuring  lymphadenopathy, arthritis, fever, weight loss, anemia and central nervous involvement.

In the wake of Osler’s (Baltimore) and Jadassohn’s (Vienna) descriptions at the beginning of the 20th century autopsy unravels nonbacterial verrucous endocarditis (Libman-Sack) and wire-loop lesions in patients with glomerulonephritis leading to neologistic construct of collagen disease (Kemperer 1941).  We now realize the overlapping of immune-complex diseases with collagen vascular diseases and the term serum sickness (see there) becomes synonymous with immune-complex disease.

The discovery of the lupus erythematosus (LE) cell by Hargraves in 1948 heralds new diagnostic tools soon to be completed with immunofluorescence studies of histological tissue sections. Animal experiments, many of them with lupus prone mice NZB/W strain have helped to develop therapeutic regimens which you can download here.
C1q binding tests detect circulating immune complexes .

Only years later, hepatitis C virus in the cryoglobulin cloak of immune-complexes, let define involved antigen in some patients. With commercial kits available, clinicians ask for immune complex detection in serum samples.

In this context, one also looks at glomerular filtration rates (GFR) performed by the kidneys in detoxifying the organism. Go to a recent paper addressing usage of
cyst/creat ratios to more precisely appreciate GFR –> Glomerular filtration rate GFR