Lief P D, Barland P, Bank N
Am J Med. 1977 Sep;63(3):441-8. doi: 10.1016/0002-9343(77)90283-2.
Six patients with glomerulonephritis were found to have granular deposits of complement and/or immunoglobulins at the dermalepidermal junction of normal skin. No patient had extrarenal clinical manifestations of systemic lupus erythematosus (SLE). The only serologic test suggestive of SLE was a positive antinuclear antibody (ANA) reaction; results of complement and antinative deoxyribonucleic acid (DNA)-antibody tests were repeatedly normal. The patients with glomerulonephritis had a favorable initial response to therapy with prednisone with or without azathioprine. These patients may represent a variant of SLE in which the diagnosis can only be established by a direct immunofluorescence test of normal skin. Alternatively, they may constitute a separate new clinical entity. Because of the favorable response to therapy, we suggest that skin immunofluorescence be performed in patients who present with unexplained glomerulonephritis and a positive ANA.
六例肾小球肾炎患者被发现其正常皮肤的真皮表皮交界处有补体和/或免疫球蛋白的颗粒状沉积。无一例患者有系统性红斑狼疮（SLE）的肾外临床表现。唯一提示SLE的血清学检查是抗核抗体（ANA）反应阳性；补体和抗天然脱氧核糖核酸（DNA）抗体检测结果反复正常。肾小球肾炎患者对泼尼松联合或不联合硫唑嘌呤治疗有良好的初始反应。这些患者可能代表SLE的一种变异型，其诊断只能通过正常皮肤的直接免疫荧光试验来确立。或者，他们可能构成一个单独的新临床实体。由于对治疗反应良好，我们建议对出现不明原因的肾小球肾炎且ANA阳性的患者进行皮肤免疫荧光检查。
