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Histological grading and staging of IgA nephropathy
Author(s) -
Shigematsu Hidekant
Publication year - 1997
Publication title -
pathology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
eISSN - 1440-1827
pISSN - 1320-5463
DOI - 10.1111/j.1440-1827.1997.tb04480.x
Subject(s) - nephropathy , pathology , fibrosis , basement membrane , medicine , extracellular matrix , glomerulonephritis , grading (engineering) , disease , mesangial proliferative glomerulonephritis , kidney , biology , ecology , microbiology and biotechnology , diabetes mellitus , endocrinology
More than 25 years have passed since immunoglobulln A (IgA) nephropathy was introduced as a disease entity inde pendent of glomerulonephritis. it has been known that more than 30% of cases have gona into end‐stage renal fallure within 20 years, indicating the presence of a chornic active group in this disease. Histologicaily this disesase is com posed of at least three types of tissue damage:(1) minimal inflammation including deposition of IgA‐containing sub stances with minor matriclal increase; (II) acute lesions char acterized by matricial damsge of glomerular basement membrane (membranolysis) and/or mesangial matrix (mes anglolysis) with inflammstory cell accumulation and/or intrinsic cell proliferation; and (III) chronic lesions mainly composed of postinfiammstory sclerosis. The progression is actually accelerated by the frequency of acute lesions, resuiting in increased glomerular scierosis focl. In such a situation, the histologic grading and stagi (G‐S)system is proposed, with the aim of having a more preclse understanding of the disease prosses. The histological grade (G) is estimated by the extent of acute giomerular and tubulointer stitial lesions, and the stage (S) is evaluated by the increase of extracellular matrices of the glomerull and inerstitial fibrosis. The evaluation of G and S is expressed semiquanti tativety for more helpful clinical use.