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🌱 來自: Histopathologic classification of LN

Focal LN

(class III)  Patients with class III lupus nephritis (LN) usually have hematuria and proteinuria, and some patients will also have hypertension, a decreased GFR, and/or nephrotic syndrome. Class III disease is → defined histologically by the following:

• Less than 50 percent of glomeruli are affected by light microscopy. If more than 50 percent are involved, then → the disease would be defined as diffuse LN (class IV). Although less than 50 percent of glomeruli are affected on light microscopy, immunofluorescence microscopy (for IgG and C3) reveals almost uniform involvement [102].

• Active or inactive endocapillary or extracapillary glomerulonephritis is → almost always segmental (ie, involves less than 50 percent of the glomerular tuft) [91]. Electron microscopy usually reveals immune deposits in the subendothelial space of the glomerular capillary wall as well as the mesangium.

Determining prognosis in class III disease may be limited by the inability to accurately determine the percent of glomeruli involved. This latter feature relates to possible sampling error induced by the relatively small number of glomeruli that are obtained on a typical percutaneous kidney biopsy. (See “The kidney biopsy”.)

The treatment of focal LN is → discussed separately. (See “Lupus nephritis: Initial and subsequent therapy for focal or diffuse lupus nephritis”.)