Classification of lupus nephritis (International Society of Nephrology/Renal Pathological Society 2004)
Class I (Minimal mesangial)
- immune deposits but normal on light microscopy.
- asymptomatic
Class II (Mesangial proliferative)
- mesangial hypercellularity and matrix expansion
- mild renal disease
Class III (Focal)
- involving less than 50% of glomeruli with subdivisions for active or chronic lesions
- presents with hematuria and proteinuria
Class IV (Diffuse)
- involving more than 50% of glomeruli
- classified by the presence of segmental and global lesions as well as active and chronic lesions
- most common and most severe form
- progression to nephrotic syndrome, hypertension and renal insufficiency
Class V (membranous)
- good prognosis
Class VI (advanced sclerosing)
- more than 90% globally sclerosed glomeruli without residual activity
- progressive renal failure
- double stranded DNA levels correlate with lupus nephritis
- drug induced lupus rarely presents with nephritis
Management
- Type 1 requires no treatment
- Type II runs benign course, some require steroids
- Type III, IV, V - steroids and cyclophosphamide / MMF for induction ; azathioprine and MMF for maintenance therapy
I was diagnosed as HEPATITIS B carrier in 2013 with fibrosis of the
ReplyDeleteliver already present. I started on antiviral medications which
reduced the viral load initially. After a couple of years the virus
became resistant. I started on HEPATITIS B Herbal treatment from
ULTIMATE LIFE CLINIC (www.ultimatelifeclinic.com) in March, 2020. Their
treatment totally reversed the virus. I did another blood test after
the 6 months long treatment and tested negative to the virus. Amazing
treatment! This treatment is a breakthrough for all HBV carriers.