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January 1979

Hereditary C2 Deficiency Associated With Cutaneous Lupus Erythematosus: Clinical, Laboratory, and Genetic Studies

Author Affiliations

Linville Meadows

From the Divisions of Dermatology (Drs Levy and Pinnell) and Rheumatic and Genetic Diseases (Dr Snyderman and Mr Meadows), Department of Medicine, and the Division of Immunology, Department of Microbiology (Dr Ward), Duke University Medical Center, Durham, NC. Drs Pinnell and Snyderman are investigators of the Howard Hughes Medical Institute. Dr Levy is in private practice in Chapel Hill, NC.

Arch Dermatol. 1979;115(1):57-61. doi:10.1001/archderm.1979.04010010029009

Selective congenital deficiency in the second component of complement has been described in association wtih lupus erythematosus (LE) and other connective tissue disorders. We identified a 59-year-old woman with a 13-year history of cutaneous LE and no detectable serum C2. The patient's photosensitivity, large polycyclic erosive cutaneous lesions, lack of renal disease, paucity of serological findings, and high incidence of bacterial infection is consistent with previously described patients with this association. Uniquely, the patient demonstrated secondary infection with Staphylococcus aureus and Trichophyton rubrum in the skin lesions themselves. Immunologic studies disclosed depression in both humoral and cellular immunity. Moderation in her clinical disease and immunologic measurements has been observed after treatment with levamisole hydrochloride. Immunogenetic studies of the patient's four-generation kindred was consistent with an autosomal recessive inheritance of C2 deficiency genetically linked to HLA, segregating with the B18 allele. Mixed lymphocyte culture determinations reinforce evidence for linkage between the HLA-D locus and the trait for C2 deficiency.

(Arch Dermatol 115:57-61, 1979)