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Physiology · Blood and immunity: immune complex clearance
Sample itemA patient with systemic lupus erythematosus has low C3 and C4 with high anti-dsDNA titres, and immune complexes lodge in the glomeruli. Which immune mechanism produces the tissue injury?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Complement activation and neutrophil recruitment by deposited immune complexes
Lupus nephritis is a type III hypersensitivity. Immune complexes deposit in the glomerular basement membrane, activate the classical complement pathway and attract neutrophils, which release enzymes and cause injury. Complement consumption explains the low C3 and C4.
Option by option
A. IgE-triggered release of preformed mast cell mediators
IgE and mast cell mediators describe type I hypersensitivity.
B. Antibody stimulation of a cell surface receptor
Antibody stimulation of a receptor, as in Graves disease, is a stimulatory variant of type II.
C. Direct cytolysis by sensitised CD8 T cells
Direct CD8 T cell killing describes type IV mechanisms.
D. Complement activation and neutrophil recruitment by deposited immune complexes (correct)
Correct. Immune complex deposition activates complement and attracts neutrophils.
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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