1989
DOI: 10.1016/s0272-6386(89)80033-2
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Clinical Outcome of Three Discrete Histologic Patterns of Injury in Severe Lupus Glomerulonephritis

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Cited by 60 publications
(41 citation statements)
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“…These histologic classes are similar to class IV-S (segmental) Ϯ V and IV-G (global) Ϯ V in the classification proposed by the International Society of Nephrology and Renal Pathology Society (ISN/RPS) (21,22), but there are important differences. In the classification used by the Lupus Nephritis Collaborative Study Group (15)(16)(17), a segmental lesion (class III Ն50%) can involve anywhere from 50% of glomeruli to all of the glomeruli in the biopsy, and there was no upper limit to the extent of involvement within each glomerulus. In contrast, the ISN/RPS classification relegates biopsies with segmental lesions that involve Ͼ50% of the glomerular tuft to class IV-G. As a result, inclusion of very widely distributed segmental lesions to ISN/RPS class IV-G could easily conceal differences in outcomes between patients with class IV-S and IV-G. Because this article addresses critical differences in outcomes in segmental and diffuse glomerular lesions on the basis of remission status, we continue to use the original classification.…”
Section: Patientsmentioning
confidence: 99%
“…These histologic classes are similar to class IV-S (segmental) Ϯ V and IV-G (global) Ϯ V in the classification proposed by the International Society of Nephrology and Renal Pathology Society (ISN/RPS) (21,22), but there are important differences. In the classification used by the Lupus Nephritis Collaborative Study Group (15)(16)(17), a segmental lesion (class III Ն50%) can involve anywhere from 50% of glomeruli to all of the glomeruli in the biopsy, and there was no upper limit to the extent of involvement within each glomerulus. In contrast, the ISN/RPS classification relegates biopsies with segmental lesions that involve Ͼ50% of the glomerular tuft to class IV-G. As a result, inclusion of very widely distributed segmental lesions to ISN/RPS class IV-G could easily conceal differences in outcomes between patients with class IV-S and IV-G. Because this article addresses critical differences in outcomes in segmental and diffuse glomerular lesions on the basis of remission status, we continue to use the original classification.…”
Section: Patientsmentioning
confidence: 99%
“…Entry criteria (27) required the histologic diagnosis of severe lupus nephritis, and the histologic diagnosis was determined prospectively by the Pathology Reading Committee of the Lupus Nephritis Collaborative Study Group (see Acknowledgments), using a modification of the 1982 WHO classification of lupus nephritis (22,30,31). An adequate biopsy contained Ͼ10 nonsclerotic glomeruli, and the diagnosis of severe lupus nephritis was based on the presence of proliferation and/or necrosis in Ն50% of the nonsclerotic glomeruli with or without concomitant membranous glomerulonephritis (27,30).…”
Section: Patientsmentioning
confidence: 99%
“…An adequate biopsy contained Ͼ10 nonsclerotic glomeruli, and the diagnosis of severe lupus nephritis was based on the presence of proliferation and/or necrosis in Ն50% of the nonsclerotic glomeruli with or without concomitant membranous glomerulonephritis (27,30). This pathologic rubric comprises three morphologically discrete forms of lupus glomerulonephritis: (1) segmental glomerulonephritis with active and/or necrotizing lesions in Ն50% of the nonsclerotic glomeruli (class III Ն50%; 24 patients; Figure 1) (22), (2) diffuse glomerulonephritis (class IV; 35 patients; Figure 2), and (3) membranous glomerulonephritis with superimposed severe segmental (Ն50% glomerular involvement) or diffuse proliferative glomerulonephritis (class Vc:Ն50% or Vd; 26 patients).…”
Section: Patientsmentioning
confidence: 99%
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“…That enhanced risk of developing nephritis earlier in the course of the disease [15]. The most frequently observed abnormality is proteinuria, our data shows common are Nephritis lupus nephritis then nephrotic disease and acute renal failure [16,17].…”
Section: Discussionmentioning
confidence: 54%