Pathology of lupus nephritis with special reference to the immunological bases of glomerular changes

Glomerular changes, and cellular and tissue responses of antibody-forming organs in 37 cases (20 cases with nephrotic syndrome and 17 cases without the syndrome) of systemic lupus erythematosus (SLE) were described. The glomerular changes were classified into 3 types, i.e., proliferative glomerulitis, membranous transformation, and wire-loop lesion from the standpoint of glomerular functional structure and its alterations. As to the responses of antibody-forming organs, hypoplasia of myeloid tissue, atrophy of lymph follicles of spleen and lymph nodes, atrophy and decrease in numbers of lymphocytes of thymus, proliferation and infiltration of plasma cells and plasmocytoid basophilic mononuclears, and proliferation of basophilic reticulum cells at the cost of differentiated antibody-forming organ tissues of bone marrow, spleen, lymph nodes, etc. were noted. Immunological bases of glomerular changes were considered and discussed in the light of pathological findings of SLE presented here and suggestions from experimental pathological studies in this field. Pathogenic roles of antigen-antibody complexes as well as anti-glomerular basement membrane (anti-GBM) antibody were considered in relation to the histologic manifestations of glomeruli in SLE or lupus nephritis.