A 20-year-old woman comes to the office due to intermittent pain and swelling of both knees over the past 3 months. She has no fever, chills, or abnormal vaginal discharge. The patient has no other medical conditions and is not sexually active. Temperature is 37.2 C (99 F), blood pressure is 150/90 mm Hg, and pulse is 78/min. Small, nontender oral ulcers are present. Examination shows mild tenderness of the knee joints but no effusion. The remainder of the examination shows no abnormalities. Laboratory results reveal anemia, thrombocytopenia, and elevated serum creatinine. Urinalysis shows proteinuria and red blood cell casts. Which of the following pathogenic mechanisms is most likely responsible for this patient's renal disease?

Question

A 20-year-old woman comes to the office due to intermittent pain and swelling of both knees over the past 3 months.  She has no fever, chills, or abnormal vaginal discharge.  The patient has no other medical conditions and is not sexually active.  Temperature is 37.2 C (99 F), blood pressure is 150/90 mm Hg, and pulse is 78/min.  Small, nontender oral ulcers are present.  Examination shows mild tenderness of the knee joints but no effusion.  The remainder of the examination shows no abnormalities.  Laboratory results reveal anemia, thrombocytopenia, and elevated serum creatinine.  Urinalysis shows proteinuria and red blood cell casts.  Which of the following pathogenic mechanisms is most likely responsible for this patient's renal disease?

Quizplus · Accepted Answer

Eductional Objective: Systemic lupus erythematosus is an autoimmune disease characterized by the formation of antinuclear antibodies (eg, anti-DNA antibodies).  Lupus nephritis occurs primarily due to the formation of immune complexes containing DNA and anti-DNA in the circulation.  These are deposited in the glomerulus where they result in complement activation, recruitment of inflammatory cells, and renal injury (type III hypersensitivity).

A 20-Year-Old Woman Comes to the Office Due to Intermittent