The classification of glomerulonephritis in systemic lupus erythematosus revisited

Jan J. Weening, Vivette D. D'Agati, Melvin M. Schwartz, Surya V. Seshan, Charles E. Alpers, Gerald B. Appel, James E. Balow, Jan A. Bruijn, Terence Cook, Franco Ferrario, Agnes B. Fogo, Ellen M. Ginzler, Lee Hebert, Gary Hill, Prue Hill, J. Charles Jennette, Norella C. Kong, Philippe Lesavre, Michael Lockshin, Lai Meng LooiHirofumi Makino, Luiz A. Moura, Michio Nagata

Research output: Contribution to journalArticle

817 Citations (Scopus)

Abstract

The currently used classification reflects our understanding of the pathogenesis of the various forms of lupus nephritis, but clinicopathologic studies have revealed the need for improved categorization and terminology. Based on the 1982 classification published under the auspices of the World Health Organization (WHO) and subsequent clinicopathologic data, we propose that class I and II be used for purely mesangial involvement (I, mesangial immune deposits without mesangial hypercellularity; II, mesangial immune deposits with mesangial hypercellularity); class III for focal glomerulonephritis (involving <50% of total number of glomeruli) with subdivisions for active and sclerotic lesions; class IV for diffuse glomerulonephritis (involving ≥50% of total number of glomeruli) either with segmental (class IV-S) or global (class IV-G) involvement, and also with subdivisions for active and sclerotic lesions; class V for membranous lupus nephritis; and class VI for advanced sclerosing lesions. Combinations of membranous and proliferative glomerulonephritis (i.e., class III and V or class IV and V) should be reported individually in the diagnostic line. The diagnosis should also include entries for any concomitant vascular or tubulointerstitial lesions. One of the main advantages of the current revised classification is that it provides a clear and unequivocal description of the various lesions and classes of lupus nephritis, allowing a better standardization and lending a basis for further clinicopathologic studies. We hope that this revision, which evolved under the auspices of the International Society of Nephrology and the Renal Pathology Society, will contribute to further advancement of the WHO classification.

Original languageEnglish
Pages (from-to)521-530
Number of pages10
JournalKidney International
Volume65
Issue number2
DOIs
Publication statusPublished - Jan 1 2004
Externally publishedYes

Fingerprint

Glomerulonephritis
Systemic Lupus Erythematosus
Lupus Nephritis
Membranous Glomerulonephritis
Terminology
Blood Vessels
Pathology
Kidney

Keywords

  • Classification
  • Glomerulonephritis
  • Lupus erythematosus

ASJC Scopus subject areas

  • Nephrology

Cite this

Weening, J. J., D'Agati, V. D., Schwartz, M. M., Seshan, S. V., Alpers, C. E., Appel, G. B., ... Nagata, M. (2004). The classification of glomerulonephritis in systemic lupus erythematosus revisited. Kidney International, 65(2), 521-530. https://doi.org/10.1111/j.1523-1755.2004.00443.x

The classification of glomerulonephritis in systemic lupus erythematosus revisited. / Weening, Jan J.; D'Agati, Vivette D.; Schwartz, Melvin M.; Seshan, Surya V.; Alpers, Charles E.; Appel, Gerald B.; Balow, James E.; Bruijn, Jan A.; Cook, Terence; Ferrario, Franco; Fogo, Agnes B.; Ginzler, Ellen M.; Hebert, Lee; Hill, Gary; Hill, Prue; Jennette, J. Charles; Kong, Norella C.; Lesavre, Philippe; Lockshin, Michael; Looi, Lai Meng; Makino, Hirofumi; Moura, Luiz A.; Nagata, Michio.

In: Kidney International, Vol. 65, No. 2, 01.01.2004, p. 521-530.

Research output: Contribution to journalArticle

Weening, JJ, D'Agati, VD, Schwartz, MM, Seshan, SV, Alpers, CE, Appel, GB, Balow, JE, Bruijn, JA, Cook, T, Ferrario, F, Fogo, AB, Ginzler, EM, Hebert, L, Hill, G, Hill, P, Jennette, JC, Kong, NC, Lesavre, P, Lockshin, M, Looi, LM, Makino, H, Moura, LA & Nagata, M 2004, 'The classification of glomerulonephritis in systemic lupus erythematosus revisited', Kidney International, vol. 65, no. 2, pp. 521-530. https://doi.org/10.1111/j.1523-1755.2004.00443.x
Weening JJ, D'Agati VD, Schwartz MM, Seshan SV, Alpers CE, Appel GB et al. The classification of glomerulonephritis in systemic lupus erythematosus revisited. Kidney International. 2004 Jan 1;65(2):521-530. https://doi.org/10.1111/j.1523-1755.2004.00443.x
Weening, Jan J. ; D'Agati, Vivette D. ; Schwartz, Melvin M. ; Seshan, Surya V. ; Alpers, Charles E. ; Appel, Gerald B. ; Balow, James E. ; Bruijn, Jan A. ; Cook, Terence ; Ferrario, Franco ; Fogo, Agnes B. ; Ginzler, Ellen M. ; Hebert, Lee ; Hill, Gary ; Hill, Prue ; Jennette, J. Charles ; Kong, Norella C. ; Lesavre, Philippe ; Lockshin, Michael ; Looi, Lai Meng ; Makino, Hirofumi ; Moura, Luiz A. ; Nagata, Michio. / The classification of glomerulonephritis in systemic lupus erythematosus revisited. In: Kidney International. 2004 ; Vol. 65, No. 2. pp. 521-530.
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