In a patient with systemic lupus erythematosus, where is serum C-reactive protein predominantly synthesized?

In a patient with systemic lupus erythematosus, serum C-reactive protein is predominantly synthesized in the liver. C-reactive protein (CRP) is an acute-phase protein that is produced primarily by hepatocytes in response to inflammation. In the context of systemic lupus erythematosus, which is characterized by widespread immune activation and inflammation, the liver increases the production of various acute-phase reactants, including CRP.

CRP plays a critical role in the immune response by binding to phosphocholine on the surface of dead or dying cells and some types of bacteria, promoting their clearance by macrophages and facilitating the complement cascade. This function is particularly important in inflammatory diseases like lupus, where there is significant immune system dysregulation.

While other tissues, such as the bone marrow and skin, have important roles in immune responses, they are not the primary sites for CRP synthesis. The kidneys do not have a significant role in CRP production. Therefore, in the context of systemic lupus erythematosus or any inflammatory condition, the liver is the correct and dominant site of synthesis for C-reactive protein.