CIRCULATING IMMUNOGLOBULIN COMPLEXES IN WEGENERS GRANULOMATOSIS

Two cases of Wegener''s granulomatosis are reported in which circulating immunoglobulin (Ig) complexes detected during the active phase of the disease disappeared during induction of remissions of active pulmonary and renal disease by immunosuppressive agents. Elevated antiglobulin activity, urinary Ig L-chain concentration and evidence of activated coagulation mechanisms were also present during active disease, and returned toward normal with treatment. Studies showed that the serum complexes did not contain DNA and demonstrated their Ig nature. Serum complement concentrations were normal, and no cryoglobulins were present. Immunofluorescent staining and electron microscopy of the kidney biopsy specimen of 1 patient showed marked fibrin deposition but no Ig or antigen-antibody deposits. Although the role of circulating Ig complexes in the pathogenesis of Wegener''s granulomatosis remains uncertain, serial changes in the parameters may provide an objective guide to activity of the disease and its response to treatment.