狼疮性肾炎PPT课件

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Class III
Focal lupus nephritis
Involves <50% glomeruli. Active or inactive lesions typically with subendothelial deposits
A: Active lesions; focal proliferative lupus nephritis
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Class IV
Diffuse lupus nephritis
Involves >50% glomeruli. Active or inactive diffuse, segmental or global endo- or
extracapillary glomerulonephritis. Typically with subendothelial deposits. Divided into
狼疮性肾炎
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狼 疮 性 肾 炎
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病因与发病机制 病理改变 临床表现
免疫学检查 诊断和治疗
预后
SFuanclitgohrts associated with development of systemic Dlruupgus:s>e1r0y0tdheesmcriabteodsiunsassociation with drug induced lupus
Global or segmental subepithelial immune deposits by light microscopy and immunofluorescence or electron microscopy, with or without mesangial changes
Epstein-Barr virus Abnormalities of apoptosis Abnormal signal transduction: toll like receptors Cytokine patterns: interferon signature; decreased interleukin 2
抗DNA抗体和免疫复合物诱导肾脏损伤 B淋巴细胞产生具有致病性的抗DNA抗体等自身抗体
辅助性T淋巴细胞参与激活B淋巴细胞 体内核小体增多或异常核小体出现
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Hale Waihona Puke 5The glomerular patterns of injury in SLE.
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International society of nephrology/renal pathology society classification of lupus nephritis(2003)
A/C: Active and chronic lesions; focal proliferative and sclerosing lupus nephritis
C: Chronic inactive lesions with glomerular scars; focal sclerosing lupus nephritis
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Diffuse proliferative glomerulonephritis (DPGN)
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The lesion of focal segmental proliferative lupus nephritis (FSGN)
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Class V
Membranous lupus nephritis
from T cells Genes: CRP and serum amyloid P genes, FcγR
receptors,programmed cell death Occupational exposure: silica, pesticides, mercury
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LN的发病机制
diffuse segmental (S) when >50% of involved glomeruli have segmental lesions and diffuse
global when >50% of involved glomeruli have global lesions
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S(A): Active lesions; diffuse segmental proliferative lupus nephritis G(A): Active lesions; diffuse global proliferative lupus nephritis S(A/C): Active and chronic lesions; diffuse segmental proliferative and sclerosing lupus nephritis G(A/C): Active and chronic lesions; diffuse global proliferative and sclerosing lupus nephritis S(C): Chronic inactive lesions with scars; diffuse segmental sclerosing lupus nephritis G(C): Chronic inactive lesions with scars; diffuse global sclerosing lupus nephritis
Class Class I
Class II
Description
Minimal mesangial lupus nephritis Normal at light microscopy Mesangial deposits on immunofluorescence
Mesangial proliferative lupus nephritis Mesangial hypercellularity or expansion with mesangial immune deposits Some subepithelial or subendothelial deposits on immunofluorescence by electron microscopy