Abstract
To clarify the involvement of complements in the pathophysiology of systemic lupus erythematosus (SLE), we investigated the association of the initial serum complement levels and their serial changes with clinical features in 60 active SLE patients.
Oral ulcer, lupus nephritis, hemolytic anemia, high levels of anti-dsDNA antibody and the presence of immune complex in SLE patients were found to contribute to decreased levels of complements (CH50, C3 or C4). It was also found that the initial levels of complement were significantly depressed in patients who had bacterial infections or aseptic necrosis of femoral head during the course of SLE or who received steroid pulse therapy.
Serial measurement of complement levels disclosed that CH50 levels were similarly normalized during 3 to 6 months of therapy both in the patients with lupus nephritis, who initially showed markedly low levels of CH50, and in those with CNS lupus who initially had slightly low levels of CH50. This suggests that hypocomplementemia in lupus nephritis is not refractory and is normalized with high doses of steroids.
24.3% of the patients remained still hypocomplementemic after 6 months of therapy. These patients had hemolytic anemia or low C4 levels before treatment more frequently than those whose complement levels were normalized.
Further study on the prognosis of the patients with continuous hypocomplementemia will be necessary.
