What pattern is described as 'full house' on immunofluorescence and with which disease is it most associated?

• A. Full House Pattern With IgG, IgA, IgM, C3, C1q; Lupus Nephritis
• B. Linear Pattern With Anti-GBM Disease
• C. Granular Pattern With IgG and C3; Membranous Nephropathy
• D. No Immune Deposits

Answer: (A)

The main idea here is recognizing specific patterns seen on immunofluorescence of glomeruli. A “full house” pattern means deposits of multiple immunoglobulins and complement components in the kidney—IgG, IgA, IgM, C3, and C1q. This broad, multi–immunoglobulin deposition is characteristic of immune complex–mediated glomerulonephritis and is most strongly associated with lupus nephritis in systemic lupus erythematosus, where diverse immune complexes form and trap these components in the glomeruli.

Understanding the contrasts helps solidify the concept: a linear pattern along the glomerular basement membrane points to anti-GBM disease; a granular pattern with only IgG and C3 is typical of membranous nephropathy; and little to no immune deposits (pauci-immune) suggests ANCA-associated vasculitis. The presence of all major immunoglobulins plus C3 and C1q—the full house—most strongly signals lupus nephritis.