Free antigen related to Anaplasma marginale (AM) (Haemobartonella) was demonstrated in the glomeruli of one patient with lupus nephritis. Indirect fluorescent antibodies against this rickettsia were demonstrated in all of 22 lupus sera tested, with titers ranging from 1:20 to 1:1280. Geometric mean titer (GMT) was 116. Fifty-eight percent of 102 controls did not react to AM by indirect fluorescent antibody technique, and GMT of all controls was 10.7 Immunofluorescence was eliminated by neutralization and blocking techniques.Systemic lupus erythematosus (SLE) is an extensively studied, often destructive systemic disorder of unknown etiology. Despite considerable resemblance to an infectious entity, no definite association has been proved with any agent (1). The Anaplasmataceae, which includes Haemobartonella, Eperythrozoon, and Anaplasma, are rickettsiae (2), which cause hypergammaglobulinemia, Coombs' positive hemolytic anemia, and erythrocyte hemagglutinins in almost all vertebrate species studied. These organisms are arthro- pod borne, share common antigens, vary widely in geographic distribution, are highly species specific, and have not been reproducibly cultivated outside the living host (3).In 1972 Kallick et a1 identified structures on erythrocytes of patients with S L E as Haemobartonellalike because of morphology as shown by fluorescent acridine orange staining, and the finding of conjugated antibody to Eperythrozoon suis and Anaplasma marginale (4).Wigand (5,6) and Kreier and Ristic (7) reported antigenic relationships among Eperythrozoon, Haemobartonella, and Anaplasma marginale (AM). Kreier and Ristic suggested that these organisms were closely related antigenically and differences between them appeared to be largely based on morphology (8). Because of the ready availability of the antigen of AM and convalescent serum available from Anaplasma infected cows (AAM), all immunofluorescent work was conducted with these materials. The authors believe that AM has immunologic and biologic significance similar to Haemobartonellae and the other Anaplasmataceae, and AM will be used through this communication in that context. We assume that Haemobartonella antigen and antibody, if available, would react similarly.This study is directed to the identification of glomerular antigen and serum antibodies related to AM in patients with SLE.
CASE REPORTMS is a 20-year-old black woman who became ill in