The classification of glomerulonephritis in systemic lupus erythematosus revisited

The classification of glomerulonephritis in systemic lupus erythematosus revisited

Author Weening, Jan J. Google Scholar
D'Agati, Vivette D. Google Scholar
Schwartz, Melvin M. Google Scholar
Seshan, Surya V. Google Scholar
Alpers, Charles E. Google Scholar
Appel, Gerald B. Google Scholar
Balow, James E. Google Scholar
Bruijn, Jan A. Google Scholar
Cook, Terence Google Scholar
Ferrario, Franco Google Scholar
Fogo, Agnes B. Google Scholar
Ginzler, Ellen M. Google Scholar
Hebert, Lee Google Scholar
Hill, Gary Google Scholar
Hill, Prue Google Scholar
Jennette, J. Charles Google Scholar
Kong, Norella C. Google Scholar
Lesavre, Philippe Google Scholar
Lockshin, Michael Google Scholar
Looi, Lai-Meng Google Scholar
Makino, Hirofumi Google Scholar
Moura, Luiz A. Autor UNIFESP Google Scholar
Nagata, Michio Google Scholar
Int Soc Nephrology Google Scholar
Renal Soc Working Grp Classificati Google Scholar
Institution Univ Amsterdam
Columbia Univ
Rush Med Coll
Cornell Univ
Univ Washington
Columbia Presbyterian Med Ctr
Leiden Univ
Imperial Coll Med Sch
San Carlo Borromeo Hosp
Vanderbilt Univ
SUNY Hlth Sci Ctr
Ohio State Univ
Georges Pompidou European Hosp
St Vincents Hosp
Univ N Carolina
Univ Kebangsaan Malaysia
Hop Necker Enfants Malad
Univ Malaya
Okayama Univ
Universidade Federal de São Paulo (UNIFESP)
Univ Tsukuba
Abstract The currently used classification reflects our understanding of the pathogenesis of the various forms of lupus nephritis, but clinicopathologic studies have revealed the need for improved categorization and terminology. Based on the 1982 classification published under the auspices of the World Health Organization (WHO) and subsequent clinicopathologic data, we propose that class I and II be used for purely mesangial involvement (I, mesangial immune deposits without mesangial hypercellularity; II, mesangial immune deposits with mesangial hypercellularity); class III for focal glomerulonephritis (involving < 50% of total number of glomeruli) with subdivisions for active and sclerotic lesions; class IV for diffuse glomerulonephritis (involving 50% of total number of glomeruli) either with segmental (class IV-S) or global (class IV-G) involvement, and also with subdivisions for active and sclerotic lesions; class V for membranous lupus nephritis; and class VI for advanced sclerosing lesions. Combinations of membranous and proliferative glomerulonephritis(i.e., class III and V or class IV and V) should be reported individually in the diagnostic line. the diagnosis should also include entries for any concomitant vascular or tubulointerstitial lesions. One of the main advantages of the current revised classification is that it provides a clear and unequivocal description of the various lesions and classes of lupus nephritis, allowing a better standardization and lending a basis for further clinicopathologic studies. We hope that this revision, which evolved under the auspices of the International Society of Nephrology and the Renal Pathology Society, will contribute to further advancement of the WHO classification.
Keywords lupus erythematosus
Language English
Date 2004-02-01
Published in Kidney International. Malden: Blackwell Publishing Inc, v. 65, n. 2, p. 521-530, 2004.
ISSN 0085-2538 (Sherpa/Romeo, impact factor)
Publisher Blackwell Publishing Inc
Extent 521-530
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000187919500017

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