Correlation of Glomerular C4d Staining with Disease Activity in Lupus Nephritis- A prospective study

The purpose of this study is to evaluate whether glomerular C4d deposition can be a useful marker of disease activity in lupus nephritis. This is a 2 years study conducted from May 2010 to April 2012. Renal biopsies from 40 patients diagnosed as lupus nephritis are taken . Lupus nephritis incidence is more common in females (90%) and the mean patient age is 26±12.9 years. The most common clinical presentation of lupus nephritis is nephrotic syndrome (67.5%). Lupus nephritis cases are classified according to ISN/RPS 2003. Class I-2 cases, class II-4 cases, class III-3 cases, class IV-12, class V-11, class VI-1, class V+IV-5 and class V+III-2 cases. Full house pattern of immunoflourescence is seen in 50% of the cases. C4d complement factor 4 breakdown product is detected by immunohistochemistry. It showed positivity in 70% of the cases. Analysis of C4d deposition with histological activity index is done, which is not significant statistically (p value 0.4). Index Terms Activity index, glomerular C4d, lupus nephritis, marker of disease activity.