Lupus nephritis classification: Difference between revisions
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==Classification== | ==Classification== | ||
The Renal Pathology Society/International Society of Nephrology (RPS/ISN) classification:<ref name="pmid147179222">{{cite journal |vauthors=Weening JJ, D'Agati VD, Schwartz MM, Seshan SV, Alpers CE, Appel GB, Balow JE, Bruijn JA, Cook T, Ferrario F, Fogo AB, Ginzler EM, Hebert L, Hill G, Hill P, Jennette JC, Kong NC, Lesavre P, Lockshin M, Looi LM, Makino H, Moura LA, Nagata M |title=The classification of glomerulonephritis in systemic lupus erythematosus revisited |journal=Kidney Int. |volume=65 |issue=2 |pages=521–30 |date=February 2004 |pmid=14717922 |doi=10.1111/j.1523-1755.2004.00443.x |url=}}</ref><ref name="pmid16861976">{{cite journal |vauthors=Furness PN, Taub N |title=Interobserver reproducibility and application of the ISN/RPS classification of lupus nephritis-a UK-wide study |journal=Am. J. Surg. Pathol. |volume=30 |issue=8 |pages=1030–5 |date=August 2006 |pmid=16861976 |doi= |url=}}</ref> | The Renal Pathology Society/International Society of Nephrology (RPS/ISN) classification:<ref name="pmid147179222">{{cite journal |vauthors=Weening JJ, D'Agati VD, Schwartz MM, Seshan SV, Alpers CE, Appel GB, Balow JE, Bruijn JA, Cook T, Ferrario F, Fogo AB, Ginzler EM, Hebert L, Hill G, Hill P, Jennette JC, Kong NC, Lesavre P, Lockshin M, Looi LM, Makino H, Moura LA, Nagata M |title=The classification of glomerulonephritis in systemic lupus erythematosus revisited |journal=Kidney Int. |volume=65 |issue=2 |pages=521–30 |date=February 2004 |pmid=14717922 |doi=10.1111/j.1523-1755.2004.00443.x |url=}}</ref><ref name="pmid16861976">{{cite journal |vauthors=Furness PN, Taub N |title=Interobserver reproducibility and application of the ISN/RPS classification of lupus nephritis-a UK-wide study |journal=Am. J. Surg. Pathol. |volume=30 |issue=8 |pages=1030–5 |date=August 2006 |pmid=16861976 |doi= |url=}}</ref><ref name="pmid15569330">{{cite journal |vauthors=Yokoyama H, Wada T, Hara A, Yamahana J, Nakaya I, Kobayashi M, Kitagawa K, Kokubo S, Iwata Y, Yoshimoto K, Shimizu K, Sakai N, Furuichi K |title=The outcome and a new ISN/RPS 2003 classification of lupus nephritis in Japanese |journal=Kidney Int. |volume=66 |issue=6 |pages=2382–8 |date=December 2004 |pmid=15569330 |doi=10.1111/j.1523-1755.2004.66027.x |url=}}</ref> | ||
=== Minimal mesangial lupus nephritis (class I) === | === Minimal mesangial lupus nephritis (class I) === | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
There is no established system for the classification of [disease name].
OR
[Disease name] may be classified according to [classification method] into [number] subtypes/groups: [group1], [group2], [group3], and [group4].
OR
[Disease name] may be classified into [large number > 6] subtypes based on [classification method 1], [classification method 2], and [classification method 3]. [Disease name] may be classified into several subtypes based on [classification method 1], [classification method 2], and [classification method 3].
OR
Based on the duration of symptoms, [disease name] may be classified as either acute or chronic.
OR
If the staging system involves specific and characteristic findings and features: According to the [staging system + reference], there are [number] stages of [malignancy name] based on the [finding1], [finding2], and [finding3]. Each stage is assigned a [letter/number1] and a [letter/number2] that designate the [feature1] and [feature2].
OR
The staging of [malignancy name] is based on the [staging system].
OR
There is no established system for the staging of [malignancy name].
Classification
The Renal Pathology Society/International Society of Nephrology (RPS/ISN) classification:[1][2][3]
Minimal mesangial lupus nephritis (class I)
Mesangial proliferative lupus nephritis (class II)
- Microscopic Hematuria
- Proteinuria
- Hypercellularity in mesangium[1]
- Light microscopy shows subendothelial deposits or segmental scars[1]
- Immunofluorescence shows subepithelial or subendothelial deposits
- Good prognosis
Focal lupus nephritis (class III)
- Less than 50% glomeruli involved
- Hematuria
- Proteinuria
- Hypertension
- Uniform involvement on immunofluorescence[1][4]
- Subendothelial immune and mesangial deposits on electron microscopy[1][5].
Subclasses on the basis of inflammatory activity of the lesions:
- Class III (A) called focal proliferative lupus nephritis: Just active lesions.[5][6]
- Class III (A/C) called focal proliferative and sclerosing lupus nephritis: Active and chronic lesions[6]
- Class III (C) called focal sclerosing lupus nephritis: Chronic inactive lesions with scarring.
Diffuse lupus nephritis (class IV)
Lupus membranous nephropathy (class V)
Advanced sclerosing lupus nephritis (class VI)
OR
- [Disease name] may be classified according to [classification method] into [number] subtypes/groups:
- [Group1]
- [Group2]
- [Group3]
- [Group4]
OR
- [Disease name] may be classified into [large number > 6] subtypes based on:
- [Classification method 1]
- [Classification method 2]
- [Classification method 3]
- [Disease name] may be classified into several subtypes based on:
- [Classification method 1]
- [Classification method 2]
- [Classification method 3]
OR
- Based on the duration of symptoms, [disease name] may be classified as either acute or chronic.
OR
- If the staging system involves specific and characteristic findings and features:
- According to the [staging system + reference], there are [number] stages of [malignancy name] based on the [finding1], [finding2], and [finding3]. Each stage is assigned a [letter/number1] and a [letter/number2] that designate the [feature1] and [feature2].
OR
- The staging of [malignancy name] is based on the [staging system].
OR
- There is no established system for the staging of [malignancy name].
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Weening JJ, D'Agati VD, Schwartz MM, Seshan SV, Alpers CE, Appel GB, Balow JE, Bruijn JA, Cook T, Ferrario F, Fogo AB, Ginzler EM, Hebert L, Hill G, Hill P, Jennette JC, Kong NC, Lesavre P, Lockshin M, Looi LM, Makino H, Moura LA, Nagata M (February 2004). "The classification of glomerulonephritis in systemic lupus erythematosus revisited". Kidney Int. 65 (2): 521–30. doi:10.1111/j.1523-1755.2004.00443.x. PMID 14717922.
- ↑ Furness PN, Taub N (August 2006). "Interobserver reproducibility and application of the ISN/RPS classification of lupus nephritis-a UK-wide study". Am. J. Surg. Pathol. 30 (8): 1030–5. PMID 16861976.
- ↑ Yokoyama H, Wada T, Hara A, Yamahana J, Nakaya I, Kobayashi M, Kitagawa K, Kokubo S, Iwata Y, Yoshimoto K, Shimizu K, Sakai N, Furuichi K (December 2004). "The outcome and a new ISN/RPS 2003 classification of lupus nephritis in Japanese". Kidney Int. 66 (6): 2382–8. doi:10.1111/j.1523-1755.2004.66027.x. PMID 15569330.
- ↑ Schwartz MM, Kawala KS, Corwin HL, Lewis EJ (August 1987). "The prognosis of segmental glomerulonephritis in systemic lupus erythematosus". Kidney Int. 32 (2): 274–9. PMID 3656940.
- ↑ 5.0 5.1 Weening JJ, D'Agati VD, Schwartz MM, Seshan SV, Alpers CE, Appel GB, Balow JE, Bruijn JA, Cook T, Ferrario F, Fogo AB, Ginzler EM, Hebert L, Hill G, Hill P, Jennette JC, Kong NC, Lesavre P, Lockshin M, Looi LM, Makino H, Moura LA, Nagata M (February 2004). "The classification of glomerulonephritis in systemic lupus erythematosus revisited". J. Am. Soc. Nephrol. 15 (2): 241–50. PMID 14747370.
- ↑ 6.0 6.1 Weening JJ, D'Agati VD, Schwartz MM, Seshan SV, Alpers CE, Appel GB, Balow JE, Bruijn JA, Cook T, Ferrario F, Fogo AB, Ginzler EM, Hebert L, Hill G, Hill P, Jennette JC, Kong NC, Lesavre P, Lockshin M, Looi LM, Makino H, Moura LA, Nagata M (February 2004). "The classification of glomerulonephritis in systemic lupus erythematosus revisited". Kidney Int. 65 (2): 521–30. doi:10.1111/j.1523-1755.2004.00443.x. PMID 14717922.