What is the typical finding on biopsy of lupus nephritis?

The typical finding on biopsy of lupus nephritis is characterized by “full house” immunofluorescence, which indicates the presence of multiple antibodies, including IgG, IgA, IgM, complement components (like C3 and C4), and often the presence of anti-dsDNA antibodies. This comprehensive immunofluorescence profile reflects the underlying pathophysiology of systemic lupus erythematosus (SLE), where a dysregulated immune response leads to the deposition of immune complexes in the kidney's glomeruli, thereby resulting in inflammation and damage.

The “full house” pattern provides crucial diagnostic information for lupus nephritis, distinguishing it from nephritis caused by other conditions. This diverse antibody reactivity can help in understanding the severity of the disease and may also correlate with clinical symptoms. Recognizing this pattern on biopsy can guide treatment decisions and prognostic considerations in patients suffering from lupus nephritis.

In contrast, other responses present either a failure to capture the complexity of lupus nephritis pathology or reflect characteristics not typical of the disease. Normal histology would not align with the inflammation and damage expected in lupus nephritis, while a biopsy showing IgG only does not encompass the full spectrum of immune responses observed. The presence of