Minimal mesangial lupus nephritis: a systematic review

Abstract

MCN is an uncommon histological class of lupus nephritis. Typically, patients present with heavy proteinuria, and transient renal dysfunction is common. The prognosis of MCN in SLE appears to be good because of its rapid response to glucocorticoids. Relapses of proteinuria may be reduced by the use of maintenance immunosuppression. Alkylating agents, calcineurin inhibitors, mycophenolate mofetil, and rituximab can be considered in glucocorticoid-dependent or refractory cases of SLE-related MCN.

Європейські Доказові Рекомендації По Діагностиці Та Лікуванню Люпус-Нефриту У Дітей: Ініціатива SHARE

“…Based on literature in adults and expert opinion, class I LN could be treated with low dose oral corticosteroid therapy (31). If other organ systems are involved and class I LN has been found, treatment choice should be guided by these other clinical features.…”

Clinical–Morphological Features and Outcomes of Lupus Podocytopathy

“…Lupus podocytopathy was divided into three groups according to morphologic features: MCD (characterized by normal glomeruli or minimal MsP [4][5][6][7][8]), MsP ( defined as $3 mesangial cells per mesangial area [11][12][13][14]), or FSGS (at least one segmental solidification of the glomerular tuft with accumulation of extracellular matrix, hyalinosis and foam cells could be present). Collapsing FSGS was defined by the presence of segmental capillary tuft collapse in at least one glomerulus with overlying podocyte hyperplasia and/or hypertrophy (25).…”

“…According to subsequent reports, SLE patients who presented with NS also showed mesangial proliferation (MsP) (11)(12)(13)(14), FSGS, or even collapsing FSGS (15,16). These patients shared common features of podocytopathy, which was called SLErelated podocytopathy or lupus podocytopathy (17,18) and might be a distinct class of LN (19,20).…”

“…Patients with lupus podocytopathy have been presented in case reports or small series over the last 20 years (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22). The prognosis of these patients remains uncertain.…”

Lupus Glomerulonephritis

“…Milder form of lupus nephritis (ISN/RPS Class I, II) is usually manageable with corticosteroids (Mok, 2010b). Azathioprine (AZA) can be added as a corticosteroid sparing agent and for the treatment of concomitant extra-renal manifestations.…”