Immunopathology: lupus band test: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Immunopathology: lupus band test

Sample item

A 28-year-old woman with arthralgia, malar rash and proteinuria has a skin biopsy from an area of normal, non-sun-exposed skin. Direct immunofluorescence shows granular deposits at the dermo-epidermal junction. Which type of reaction do these deposits represent?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Immune complex deposition

The lupus band test shows granular IgG, IgM and complement along the dermo-epidermal junction, even in uninvolved skin. SLE is the prototype type III hypersensitivity disease, in which circulating immune complexes deposit in tissue and activate complement.

Option by option

  • A. T cell-mediated cytotoxicity

    T-cell cytotoxicity does not leave immunoglobulin deposits.

  • B. IgE-mediated mast cell degranulation

    IgE reactions are immediate type I and do not produce a junctional band.

  • C. Immune complex deposition (correct)

    Correct. Granular deposits at the junction are immune complexes of type III hypersensitivity.

  • D. Antibody binding to cell surface antigens

    Cell-surface antibody binding is type II and gives linear or intercellular patterns.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is C, Immune complex deposition. The lupus band test shows granular IgG, IgM and complement along the dermo-epidermal junction, even in uninvolved skin.

Why is "T cell-mediated cytotoxicity" not the answer?

T-cell cytotoxicity does not leave immunoglobulin deposits.

Why is "IgE-mediated mast cell degranulation" not the answer?

IgE reactions are immediate type I and do not produce a junctional band.

Why is "Antibody binding to cell surface antigens" not the answer?

Cell-surface antibody binding is type II and gives linear or intercellular patterns.

What concept does this question test?

It tests Immunopathology: lupus band test in Pathology. SLE is the prototype type III hypersensitivity disease, in which circulating immune complexes deposit in tissue and activate complement.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Immunopathology: lupus band test?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.