Rheumatology

Question 1

Lupus nephritis

Answer 1

• common as first presentation in children, may be only symptom at the time
• Immune complex mediated
• aberrations in both T and B cells

WHO class I:
no histological abn

WHO II:

• mesangial deposits in glomeruli containing immunoglobulin and complement
• can also have mesangial hypercellularity and increased matrix

II:
focal segmental GN with mesangial deposits throughout most of glomeruli and subendothelial deposits between epithelial cells and GBM
- may have crescent formation and sclerosis

IV:
Diffuse changes and most severe form
- all glomeruli involved
- all have mesangial proliferation
- capillary walls thickened creating "wire loop lesion"

V:
Least common
membranous lupus nephritis
idiopathic membranous glomerulopathy on histology but also with some mesangial proliferation