Vasculitis:
acute necrotizing vasculitis due to type III HS is found in many tissues and forms the pathological basis of involvement of any organs
fibrinoid deposits within vessel walls containing antibody, DNA, complement fragments, and fibrinogen: aka fibrinoid necrosis
In chronic stages, vessels show fibrous thickening with luminal narrowing
Kidney:
Renal failure is the most common cause of death
DNA/anti-DNA complexes within the glomeruli
Mesangial lupus glomerulonephritis
Focal proliferative glomerulonephritis
Diffuse proliferative glomerulonephritis
Membranous glomerulonephritis
Skin:
erythematous or maculopapular eruption over the malar eminences and bridge of the nose ("butterfly pattern“)
Photosensitivity
Immunofluorescence microscopy reveals deposition of Ig and complement at the dermoepidermal junction
Joint involvement:
Erosion of the membranes and destruction of articular cartilage like in RA is very uncommon
Central nervous system:
focal neurologic deficits and/or neuropsychiatric symptoms
multifocal cerebral microinfarcts
thrombosis caused by antiphospholipid antibodies
Spleen:
follicular hyperplasia with numerous plasma cells in the red pulp
Central penicilliary arteries characteristically show thickening and perivascular fibrosis, producing onion-skin lesions
Serositis:
serous effusions to fibrinous exudates and progressing to fibrous opacification in the chronic stage
Heart:
Pericarditis, myocarditis and endocarditis all may be seen
Libman-Sacks endocarditis / nonbacterial verrucous( thrombotic) endocarditis
coronary artery disease
Accelerated atherosclerosis
Lungs:
lungs may reveal interstitial fibrosis.
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