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Diffuse lupus nephritis

MedGen UID:
883248
•Concept ID:
C4053955
•
Disease or Syndrome
Synonyms: Class IV lupus nephritis; Systemic Lupus Erythematosus Nephritis Class IV
 
HPO: HP:0033727

Definition

A subclass of lupus nephritis with active or inactive diffuse, segmental or global endocapillary or extracapillary glomerulonephritis involving at least 50% of all glomeruli, typically with diffuse subendothelial immune deposits, with or without mesangial alterations. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVDiffuse lupus nephritis

Professional guidelines

PubMed

Systemic lupus erythematosus and diffuse alveolar hemorrhage, etiology and novel treatment strategies.
Al-Adhoubi NK, Bystrom J
Lupus 2020 Apr;29(4):355-363. Epub 2020 Feb 9 doi: 10.1177/0961203320903798. PMID: 32036761Free PMC Article
Treatment for lupus nephritis.
Flanc RS, Roberts MA, Strippoli GF, Chadban SJ, Kerr PG, Atkins RC
Cochrane Database Syst Rev 2004;(1):CD002922. doi: 10.1002/14651858.CD002922.pub2. PMID: 14973998
Diffuse and focal proliferative lupus nephritis: treatment approaches and results.
Pollak VE, Kant KS, Hariharan S
Nephron 1991;59(2):177-93. doi: 10.1159/000186550. PMID: 1956480

Recent clinical studies

Etiology

Glomerular Disease in Temporal Association with SARS-CoV-2 Vaccination: A Series of 29 Cases.
Caza TN, Cassol CA, Messias N, Hannoudi A, Haun RS, Walker PD, May RM, Seipp RM, Betchick EJ, Amin H, Ziadie MS, Haderlie M, Eduwu-Okwuwa J, Vancea I, Seek M, Elashi EB, Shenoy G, Khalillullah S, Flaxenburg JA, Brandt J, Diamond MJ, Frome A, Kim EH, Schlessinger G, Ulozas E, Weatherspoon JL, Hoerschgen ET, Fabian SL, Bae SY, Iqbal B, Chouhan KK, Karam Z, Henry JT, Larsen CP
Kidney360 2021 Nov 25;2(11):1770-1780. Epub 2021 Sep 16 doi: 10.34067/KID.0005372021. PMID: 35372991Free PMC Article
Value of a complete or partial remission in severe lupus nephritis.
Chen YE, Korbet SM, Katz RS, Schwartz MM, Lewis EJ; Collaborative Study Group
Clin J Am Soc Nephrol 2008 Jan;3(1):46-53. Epub 2007 Nov 14 doi: 10.2215/CJN.03280807. PMID: 18003764Free PMC Article
A randomized pilot trial comparing cyclosporine and azathioprine for maintenance therapy in diffuse lupus nephritis over four years.
Moroni G, Doria A, Mosca M, Alberighi OD, Ferraccioli G, Todesco S, Manno C, Altieri P, Ferrara R, Greco S, Ponticelli C
Clin J Am Soc Nephrol 2006 Sep;1(5):925-32. Epub 2006 Jun 28 doi: 10.2215/CJN.02271205. PMID: 17699309
Long-term prognosis of diffuse lupus nephritis.
Ponticelli C, Zucchelli P, Moroni G, Cagnoli L, Banfi G, Pasquali S
Clin Nephrol 1987 Dec;28(6):263-71. PMID: 3327639
Silent diffuse lupus nephritis: long-term follow-up.
Leehey DJ, Katz AI, Azaran AH, Aronson AJ, Spargo BH
Am J Kidney Dis 1982 Jul;2(1 Suppl 1):188-96. PMID: 7048906

Diagnosis

Recurrent abdominal pain and vomiting with elevated triglyceride and positive antinuclear antibody in a girl aged 12 years.
Fang YH, Lin HH, Lou JG, Chen J
Zhongguo Dang Dai Er Ke Za Zhi 2022 Aug 15;24(8):917-922. doi: 10.7499/j.issn.1008-8830.2203006. PMID: 36036131Free PMC Article
AJKD Atlas of Renal Pathology: Focal and Diffuse Lupus Nephritis (ISN/RPS Class III and IV).
Fogo AB, Lusco MA, Najafian B, Alpers CE
Am J Kidney Dis 2017 Aug;70(2):e9-e11. doi: 10.1053/j.ajkd.2017.06.001. PMID: 28739130
Fulminant systemic vasculitis in systemic lupus erythematosus. Case report and review of the literature.
Medina G, González-Pérez D, Vázquez-Juárez C, Sánchez-Uribe M, Saavedra MA, Jara LJ
Lupus 2014 Nov;23(13):1426-9. Epub 2014 Aug 8 doi: 10.1177/0961203314546018. PMID: 25107938
Long-term prognosis of diffuse lupus nephritis.
Ponticelli C, Zucchelli P, Moroni G, Cagnoli L, Banfi G, Pasquali S
Clin Nephrol 1987 Dec;28(6):263-71. PMID: 3327639
Progression of mesangial and focal to diffuse lupus nephritis.
Ginzler EM, Nicastri AD, Chen CK, Friedman EA, Diamond HS, Kaplan D
N Engl J Med 1974 Oct 3;291(14):693-6. doi: 10.1056/NEJM197410032911402. PMID: 4604972

Therapy

Glomerular Disease in Temporal Association with SARS-CoV-2 Vaccination: A Series of 29 Cases.
Caza TN, Cassol CA, Messias N, Hannoudi A, Haun RS, Walker PD, May RM, Seipp RM, Betchick EJ, Amin H, Ziadie MS, Haderlie M, Eduwu-Okwuwa J, Vancea I, Seek M, Elashi EB, Shenoy G, Khalillullah S, Flaxenburg JA, Brandt J, Diamond MJ, Frome A, Kim EH, Schlessinger G, Ulozas E, Weatherspoon JL, Hoerschgen ET, Fabian SL, Bae SY, Iqbal B, Chouhan KK, Karam Z, Henry JT, Larsen CP
Kidney360 2021 Nov 25;2(11):1770-1780. Epub 2021 Sep 16 doi: 10.34067/KID.0005372021. PMID: 35372991Free PMC Article
Outcomes of maintenance therapy with tacrolimus versus azathioprine for active lupus nephritis: a multicenter randomized clinical trial.
Chen W, Liu Q, Chen W, Tang X, Fu P, Liu F, Liao Y, Yang Z, Zhang J, Chen J, Lou T, Fu J, Kong Y, Liu Z, Li Z, Yu X
Lupus 2012 Aug;21(9):944-52. Epub 2012 Mar 21 doi: 10.1177/0961203312442259. PMID: 22438027
A randomized pilot trial comparing cyclosporine and azathioprine for maintenance therapy in diffuse lupus nephritis over four years.
Moroni G, Doria A, Mosca M, Alberighi OD, Ferraccioli G, Todesco S, Manno C, Altieri P, Ferrara R, Greco S, Ponticelli C
Clin J Am Soc Nephrol 2006 Sep;1(5):925-32. Epub 2006 Jun 28 doi: 10.2215/CJN.02271205. PMID: 17699309
Long-term prognosis of diffuse lupus nephritis.
Ponticelli C, Zucchelli P, Moroni G, Cagnoli L, Banfi G, Pasquali S
Clin Nephrol 1987 Dec;28(6):263-71. PMID: 3327639
Silent diffuse lupus nephritis: long-term follow-up.
Leehey DJ, Katz AI, Azaran AH, Aronson AJ, Spargo BH
Am J Kidney Dis 1982 Jul;2(1 Suppl 1):188-96. PMID: 7048906

Prognosis

Fulminant systemic vasculitis in systemic lupus erythematosus. Case report and review of the literature.
Medina G, González-Pérez D, Vázquez-Juárez C, Sánchez-Uribe M, Saavedra MA, Jara LJ
Lupus 2014 Nov;23(13):1426-9. Epub 2014 Aug 8 doi: 10.1177/0961203314546018. PMID: 25107938
Th1/Th2 balance of SLE patients with lupus nephritis.
Nakashima H, Akahoshi M, Masutani K
Rinsho Byori 2006 Jul;54(7):706-13. PMID: 16913661
Long-term prognosis of diffuse lupus nephritis.
Ponticelli C, Zucchelli P, Moroni G, Cagnoli L, Banfi G, Pasquali S
Clin Nephrol 1987 Dec;28(6):263-71. PMID: 3327639
Silent diffuse lupus nephritis: long-term follow-up.
Leehey DJ, Katz AI, Azaran AH, Aronson AJ, Spargo BH
Am J Kidney Dis 1982 Jul;2(1 Suppl 1):188-96. PMID: 7048906
Progression of mesangial and focal to diffuse lupus nephritis.
Ginzler EM, Nicastri AD, Chen CK, Friedman EA, Diamond HS, Kaplan D
N Engl J Med 1974 Oct 3;291(14):693-6. doi: 10.1056/NEJM197410032911402. PMID: 4604972

Clinical prediction guides

Recurrent abdominal pain and vomiting with elevated triglyceride and positive antinuclear antibody in a girl aged 12 years.
Fang YH, Lin HH, Lou JG, Chen J
Zhongguo Dang Dai Er Ke Za Zhi 2022 Aug 15;24(8):917-922. doi: 10.7499/j.issn.1008-8830.2203006. PMID: 36036131Free PMC Article
Th1/Th2 balance of SLE patients with lupus nephritis.
Nakashima H, Akahoshi M, Masutani K
Rinsho Byori 2006 Jul;54(7):706-13. PMID: 16913661
Ultrastructural 'fingerprint' in cryoprecipitates and glomerular deposits: a clinicopathologic analysis of fingerprint deposits.
Su CF, Chen HH, Yeh JC, Chen SC, Liu CC, Tzen CY
Nephron 2002 Jan;90(1):37-42. doi: 10.1159/000046312. PMID: 11744803
Patterns of renal injury in systemic lupus erythematosus: light and immunofluorescence microscopic observations.
Grishman E, Gerber MA, Churg J
Am J Kidney Dis 1982 Jul;2(1 Suppl 1):135-41. PMID: 6213149

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