3/29/2024 0 Comments C4d costSystemic lupus erythematous (SLE) is an autoimmune disease with a wide variety of clinical manifestations and serological abnormalities ( 1). Multivariate Cox hazard analysis showed that co-deposition of arteriolar C4d and C3c was an independent risk factor (HR: 3.681, 95% CI 1.519–8.921, P = 0.004) for predicting renal outcomes. During the mean follow-up of 55.8 months, arteriolar C4d was related to worse renal outcomes. Patients with arteriolar C4d deposition were more likely to develop RVLs (91.2%) compared to those with no arteriolar C4d deposition (78.0% P = 0.004), especially with two or more types of RVLs ( P < 0.001). Patients with TBM C4d staining had higher disease activity (measured with the Systemic Lupus Erythematous Disease Activity Index) and higher National Institutes of Health pathological activity and chronicity indices (all P < 0.01). These deposits were localized in the glomeruli (98.2%), tubular basement membrane (TBM) (43.7%), arterioles (31.4%), and peritubular capillary (33.8%). C4d deposition was present in most (98.8%) renal specimens in our cohort.
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