Lupus Nephritis

Question 1

Identify the class of lupus nephritis:
- very uncommon
- characterized by immune complex deposition in the mesangium
- identified by immunofluorescense and by electron microscopy
- no structural changes on light microscopy

Answer 1

Class I : Minimal Mesangial Lupus Nephritis

Question 2

Identify the class of lupus nephritis:
- characterized by mesangial cell proliferation
- with accumulation of mesangial matrix
- granular mesangial deposits of immunoglobulin and complement without involvement of glomerular capillaries

Answer 2

Class II: Mesangial Proliferative Lupus Nephritis

Question 3

Identify the class of lupus nephritis:
- Microscopic characteristics involvement of fewer than 50% of glomeruli
- lesions may be segmental ( affecting only a portion of the glomerulus) or global ( involving the entire glomerulus)
- frequently with extra capillary proliferation associated with focal necrosis and crescent formation

Answer 3

Class III: Focal Lupus Nephritis

Question 4

Identify the class of lupus nephritis:
Clinical presentation
- ranges from mild hematuria to proteinuria to acute renal insufficiency
- RBCs cell casts in the urine ( active disease)

Answer 4

Class III: Focal Lupus Nephritis

Question 5

Identify the class of lupus nephritis:
Complications
- some patients progress to diffuse glomerulonephritis
- active or proliferative inflammatory lesions can heal or lead to chronic global or segmental glomerular scarring

Answer 5

Class III : Focal Lupus Nephritis

Question 6

Most common and severe form of lupus nephritis?

Answer 6

Class IV: Diffuse Lupus Nephritis

Question 7

Identify the class of lupus nephritis:
Microscopic findings
- the lesions are similar to those class III
- half or more of the glomeruli are affected

Answer 7

Class IV : Diffuse Lupus Nephritis

Question 8

Identify the class of lupus nephritis:
Special feature:
- involved glomeruli show proliferation of endothelial, mesangial, and epithelial cells producing cellular crescents that fill Bowmans space.
- wire loop structures in light microscopy
- immune complexes can be ready detected by electron microscopy and immunofluorescence

Answer 8

Class IV: Diffuse Lupus Nephritis

Question 9

Identify the class of lupus nephritis:
Clinical presentation
- usually symptomatic, showing hematuria as well as proteinuria
- hypertension
- mild to severe renal insufficiency

Answer 9

Class IV: Diffuse Lupus Nephritis

Question 10

Identify the class of lupus nephritis:
Microscopic characteristics
- diffuse thickening of the capillary walls due to deposition of subepithelial immune complexes
- similar to idiopathic membranous nephropathy
- immune complexes usually accompanied by increased production of basement membrane-like material

Answer 10

Class V : Membranous Lupus Nephritis

Question 11

Identify the class of lupus nephritis:
Clinical presentation usually causes severe proteinuria or nephrotic syndrome

Answer 11

Class V: Membranous Lupus Nephritis

Question 12

Identify the class of lupus nephritis:
Sclerosis of more than 90% of the glomeruli

Answer 12

Class VI: Advanced Sclerosing Lupus Nephritis

Question 13

Identify the class of lupus nephritis:
Represents end-stage renal disease

Answer 13

Class VI: Advanced Sclerosing Lupus Nephritis