New patterns of immunoglobulin deposition in the lesions of malignant nephrosclerosis, with special reference to IgE.

Localization of immunoglobulins (including IgE), complement and fibrinogen and the morphologic alterations in the kidneys of 10 patients with malignant nephrosclerosis were investigated. Thirteen kidneys with benign nephrosclerosis and 5 normal ones were also studied. In contrast to a previous series of patients with malignant nephrosclerosis, the number of necrotic arterioles and the deposition of IgG and complement in the renal arterioles, were reduced in a parallel fashion. These differences seem to reflect modern treatment and support the hypothesis that IgG and complement play a role in the pathogenesis of the arteriolar necrosis in the disease. IgE was deposited massively in many renal arterioles of 9 patients with malignant nephrosclerosis. The role of reaginic antibody in the pathogenesis of the disease is not clear since IgE was also focally present in some arterioles of 4 normal kidneys and of 8 kidneys with benign nephrosclerosis.