Histopatološke značilnosti lupusnega nefritisa
Histopathological changes in lupus nephritis

slovenian

2021

volume 60, issue 4

classification   histopathology   lupus nephritis

Društvo Medicinski razgledi
(Obvezni izvod spletne publikacije)

Renal impairment is the most important cause of morbidity and mortality in systemic lupus erythematosus. It is the result of immune complex deposition in different areas of renal tissue and the activation of a immune response. The most common deposits are found in the mesangial, subendothelial and subepithelial spaces. The localization of deposits is associated with clinical presentation. Some histological features, such as the presence and extent of glomerular crescents, are associated with the long-term prognosis of the disease and its treatment response. Renal biopsy enables the precise determination of active and chronic lesions in lupus nephritis, which is important for appropriate treatment strategy. Therefore, in 2018, an international nephropathology working group proposed a modification of the valid classification system with improved clarity of definitions to improve the assessment of histologic patterns and its reproducibility. In the review article, we summarize the pathohistological characteristics of individual classes of lupus nephritis in their dependence on the clinical picture. We focus on the prognostic factors of individual histological images, the importance of the activity and chronicity indexes, and differential diagnostic patterns of injury that may obscure and complicate the diagnosis of lupus nephritis.

03.07.2023