Aggravating factor in lupus nephritis; electron microscopic observation

47 renal biopsies from 36 patients with SLE were examined in detail to compare with clinical courses and ultrastructural findings. Of 36 patients, 8 cases were free from renal involvement. The severity of electron dense deposits in glomeruli with lupus nephritis were generally well correlated with each clinical feature obtained. Moreover, mesangiocapillary cell proliferation was considered to be the main morphological promoting factor in poor prognosis of the lupus nephritis. Prominent circumferential subendothelial dense deposits were suggested to enhance to enhance the proliferation of mesangial cells, mostly with a mode of circumferential interposition. In each deposit with lapse of time and/or treatments, subepithelial deposits were gradually degraded to granular material but not lucent, though most subendothelial deposits rapidly disappeared without any remnant structure or with only a few flocculent materials. Mesangial deposits were mostly stabilized and rarely turned membranous.