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🌱 來自: Histopathologic classification of LN

Diffuse LN

(class IV) Class IV LN is → the most common histologic pattern and most severe form of lupus nephritis (LN) [103]. Hematuria and proteinuria are present in virtually all patients with active class IV disease, and nephrotic syndrome, hypertension, and reduced GFR are all frequently seen. Affected patients typically have significant hypocomplementemia (especially C3) and elevated anti-dsDNA levels, especially during active disease [104].

Class IV LN is → defined histologically by the following:

• More than 50 percent of glomeruli are affected by light microscopy (picture 3). If less than 50 percent are involved, then → the disease would be defined as focal LN (class III).

• Affected glomeruli display endocapillary with or without extracapillary glomerulonephritis. Mesangial abnormalities may also be observed. Electron microscopy reveals subendothelial deposits, at ↣ least during the active phase (picture 1). The presence of diffuse wire loop deposits, but with little or no glomerular proliferation, is → also considered class IV disease.