Here are electron microscopy & immunofluorescent images of the glomeruli in a patient with SLE.

You can review your basic knowledge of the glomerular architecture on the next page.

Can you determine where the capillary lumen is? Working your way out, examine the capillary wall and then the mesangium.

To what and where are the arrows pointing ?

How is the immunofluorescent stain performed? What do you think is being stained in the SLE kidney?

The electron microscopy image shows subendothelial deposits (blue arrows, EM1) that are responsible for the "Wire-loop" changes seen histologically. In addition to subendothelial deposits, there is a solitary subendothelial deposit (red arrow, EM1), as well as numerous mesangial deposits (red arrows, EM2). Looking for RBCs can help you identify the capillary lumen. Immune deposits tend to have a "fingerprint" appearance (EM 3). Glomeruli in lupus nephritis can stain diffusely for IgG, IgA, IgM, complement components C1q, C3 or all five (the so-called "full house" staining). The I.F. image shows IgG. To visualize the IgG, a histologic section is stained with fluorescently-conjugated anti-IgG antibodies (e.g. anti-human IgG antibody raised in goats).