Revision of the International Society of Nephrology/Renal Pathology Society classification for lupus nephritis: clarification of definitions, and modified National Institutes of Health activity and chronicity indices

被引：679

作者：

Bajema, Ingeborg M. ^{[1
]}

Wilhelmus, Suzanne ^{[1
]}

Alpers, Charles E. ^{[2
]}

Bruijn, Jan A. ^{[1
]}

Colvin, Robert B. ^{[3
]}

Cook, H. Terence ^{[4
]}

D'Agati, Vivette D. ^{[5
]}

Ferrario, Franco ^{[6
]}

Haas, Mark ^{[7
]}

Jennette, J. Charles ^{[8
]}

Joh, Kensuke ^{[9
]}

Nast, Cynthia C. ^{[7
]}

Noel, Laure-Helene ^{[10
]}

Rijnink, Emilie C. ^{[1
]}

Roberts, Ian S. D. ^{[11
]}

Seshan, Surya V. ^{[12
]}

Sethi, Sanjeev ^{[13
]}

Fogo, Agnes B. ^{[14
]}

机构：

[1] Leiden Univ, Dept Pathol, Med Ctr, POB 9600, NL-2300 RC Leiden, Netherlands

[2] Univ Washington, Dept Pathol, Seattle, WA 98195 USA

[3] Harvard Med Sch, Massachusetts Gen Hosp, Dept Pathol, Boston, MA USA

[4] Imperial Coll, Dept Med, London, England

[5] Columbia Univ, Med Ctr, Dept Pathol & Cell Biol, New York, NY USA

[6] Milan Bicocca Univ, San Gerardo Hosp Monza, Nephropathol Ctr, Milan, Italy

[7] Cedars Sinai Med Ctr, Dept Pathol & Lab Med, Los Angeles, CA 90048 USA

[8] Univ North Carolina Chapel Hill, Dept Pathol & Lab Med, Chapel Hill, NC USA

[9] Tohoku Univ, Grad Sch Med, Dept Pathol, Sendai, Miyagi, Japan

[10] Hop Necker Enfants Malad, Dept Pathol, Paris, France

[11] Oxford Univ Hosp, Dept Cellular Pathol, Oxford, England

[12] Weill Cornell Univ Med Ctr, Dept Pathol & Lab Med, New York, NY USA

[13] Mayo Clin Rochester, Dept Lab Med & Pathol, Rochester, MN USA

[14] Vanderbilt Univ, Sch Med, Dept Pathol, Nashville, TN 37212 USA

来源：

KIDNEY INTERNATIONAL | 2018年 / 93卷 / 04期

关键词：

lupus nephritis; renal biopsy; systemic lupus erythematosus; OXFORD CLASSIFICATION; ERYTHEMATOSUS; LESIONS; GLOMERULONEPHRITIS; REPRODUCIBILITY; SYSTEM;

D O I：

10.1016/j.kint.2017.11.023

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

We present a consensus report pertaining to the improved clarity of definitions and classification of glomerular lesions in lupus nephritis that derived from a meeting of 18 members of an international nephropathology working group in Leiden, Netherlands, in 2016. Here we report detailed recommendations on issues for which we can propose adjustments based on existing evidence and current consensus opinion (phase 1). New definitions are provided for mesangial hypercellularity and for cellular, fibrocellular, and fibrous crescents. The term "endocapillary proliferation" is eliminated and the definition of endocapillary hypercellularity considered in some detail. We also eliminate the class IV-S and IV-G subdivisions of class IV lupus nephritis. The active and chronic designations for class III/IV lesions are replaced by a proposal for activity and chronicity indices that should be applied to all classes. In the activity index, we include fibrinoid necrosis as a specific descriptor. We also make recommendations on issues for which there are limited data at present and that can best be addressed in future studies (phase 2). We propose to proceed to these investigations, with clinicopathologic studies and tests of interobserver reproducibility to evaluate the applications of the proposed definitions and to classify lupus nephritis lesions.

引用

页码：789 / 796

页数：8

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