Lupus Nephritis

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Summary1)First Aid for the Basic Sciences: Organ Systems by Tao Le

Lupus Nephritis is a part of the pathophysiologic spectrum of SLE.

Pathophysiology2)Lupus Nephritis (Wikipedia)

Histology – Increased mesangial matrix and mesangial hypercellularity (Wikipedia)

Lupus nephritis is an inflammation of the kidney caused by systemic lupus erythematosus (SLE), a disease of the immune system.

Stage I (minimal mesangial) disease has a normal appearance under light microscopy, but mesangial deposits are visible under electron microscopy.

Stage II disease (mesangial proliferative) is noted by mesangial hypercellularity and matrix expansion. Stage III disease (focal lupus nephritis) is indicated by sclerotic lesions involving less than 50% of the glomeruli, which can be segmental or global, and active or chronic, with endocapillary or extracapillary proliferative lesions.

Stage IV lupus nephritis (diffuse proliferative) is both the most severe, and the most common subtype. More than 50% of glomeruli are involved. Lesions can be segmental or global, and active or chronic, with endocapillary or extracapillary proliferative lesions. Stage V (membranous lupus nephritis) is characterized by diffuse thickening of the glomerular capillary wall (segmentally or globally), with diffuse membrane thickening, and subepithelial deposits seen under electron microscopy.

Clinically, stage V presents with signs of nephrotic syndrome. A final stage is usually included by most practitioners, stage VI, or advanced sclerosing lupus nephritis. It is represented by Global sclerosis involving more than 90% of glomeruli, and represents healing of prior inflammatory injury.

Causes3)First Aid for the Basic Sciences: Organ Systems by Tao Le

  • Systemic Lupus Erythematosus

Symptoms 4)First Aid for the Basic Sciences: Organ Systems by Tao Le

  • Weight Gain
  • High BP
  • Dark foamy Urine
  • Swelling around the eyes, legs, ankles or fingers

Diagnosis 5)First Aid for the Basic Sciences: Organ Systems by Tao Le

  • Renal Biopsy – range from mesangial involvement to membranous nephritis

Gross Pathology – Classic flea-bitten appearance of the cortical surface of the kidney in diffuse proliferative nephritis (Wikipedia)

Treatment 6)First Aid for the Basic Sciences: Organ Systems by Tao Le

  • SLE treatment
  • Corticosteroids
  • Immunosuppressant
  • Symptomatic

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