IgA nephropathy classification: Difference between revisions
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{{IgA nephropathy}} | |||
{{CMG}}; {{APM}}; {{AE}} {{OO}} | |||
{{ | ==Overview== | ||
[[IgA nephropathy]] may be classified according to its association to other pathology or by its histological features. When [[IgA nephropathy]] occurs in isolation, it is called "primary IgA nephropathy". In converse, if [[IgA nephropathy]] is a consequence of a more systemic disease, it is called "secondary IgA nephropathy". Additionally, [[IgA nephropathy]] may be histologically classified according to the '''oxford classification''' of [[IgA nephropathy]] as [[Mesangium|mesangial hypercellularity]], [[Glomerulosclerosis|segmental glomerulosclerosis]], endocapillary hypercellularity, or tubular atrophy/interstitial fibrosis. | |||
==Classification== | |||
IgA nephropathy may be classified according to its association to other pathology or by its histological features. | |||
=== Classification by Associated Pathology === | |||
[[IgA nephropathy]] may be classified according to its association to other [[pathology]] (or lack there of) as follows: | |||
====Primary IgA Nephropathy==== | |||
:When [[IgA nephropathy]] occurs alone, it is called "primary IgA nephropathy". It is thus not secondary to any chronic concomitant disease. Before the diagnosis of primary [[IgA nephropathy]] is made, secondary causes need to be ruled out. | |||
====Secondary IgA Nephropathy==== | |||
:When [[IgA nephropathy]] occurs secondary to other chronic or systemic diseases, it is called “secondary IgA nephropathy”. Secondary causes of [[IgA nephropathy]] should be ruled out because secondary causes may alter the management plan and probably the [[prognosis]] too. | |||
=== Classification by Histological Features === | |||
The pathologic classification of IgA nephropathy has been developed by the International IgA Nephropathy Network together with the Renal Pathology Society. This classification is called “'''The Oxford classification of IgA nephropathy'''”. This classification was done after a 5 years [[retrospective study]] on clinical data and kidney biopsies were obtained from 265 patients and multiple pathohistological analyses were done on the kidney specimens <ref name="pmid19571791">{{cite journal| author=Working Group of the International IgA Nephropathy Network and the Renal Pathology Society. Cattran DC, Coppo R, Cook HT, Feehally J, Roberts IS et al.| title=The Oxford classification of IgA nephropathy: rationale, clinicopathological correlations, and classification. | journal=Kidney Int | year= 2009 | volume= 76 | issue= 5 | pages= 534-45 | pmid=19571791 | doi=10.1038/ki.2009.243 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19571791 }} </ref>. | |||
* IgAN is then histologically classified as: | |||
**[[Mesangial cell|Mesangial]] hypercellularity | |||
**Segmental [[glomerulosclerosis]] | |||
**Endocapillary hypercellularity | |||
**Tubular [[atrophy]]/[[interstitial fibrosis]] | |||
{| | |||
! style="background:#4479BA; color: #FFFFFF;" align="center" |'''Histological Features''' | |||
! style="background:#4479BA; color: #FFFFFF;" align="center" |'''Description''' | |||
|- | |||
! style="padding: 5px 5px; background: #DCDCDC;" |Mesangial hypercellularity | |||
|In the glomerular mesangium, four or more mesangial cells are noted. | |||
|- | |||
! style="padding: 5px 5px; background: #DCDCDC;" |Segmental glomerulosclerosis | |||
|In the capillary lumen of the glomerulus, a higher density of cells is noted. | |||
|- | |||
! style="padding: 5px 5px; background: #DCDCDC;" |Endocapillary hypercellularity | |||
|Focal and not the whole obliteration of the capillary lumen by matrix material eads to the formation of adhesions or sclerosis. | |||
|- | |||
! style="padding: 5px 5px; background: #DCDCDC;" |Tubular atrophy/interstitial fibrosis | |||
|An estimated percentage of interstitial fibrosis or tubular atrophy is calculated. The more common feature represents the main pathology present. | |||
|} | |||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
{{WH}}{{WS}} | |||
Latest revision as of 13:15, 18 July 2018
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IgA nephropathy Microchapters |
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Treatment |
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Case Studies |
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IgA nephropathy classification On the Web |
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American Roentgen Ray Society Images of IgA nephropathy classification |
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Risk calculators and risk factors for IgA nephropathy classification |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Ali Poyan Mehr, M.D. [2]; Associate Editor(s)-in-Chief: Olufunmilola Olubukola M.D.[3]
Overview
IgA nephropathy may be classified according to its association to other pathology or by its histological features. When IgA nephropathy occurs in isolation, it is called "primary IgA nephropathy". In converse, if IgA nephropathy is a consequence of a more systemic disease, it is called "secondary IgA nephropathy". Additionally, IgA nephropathy may be histologically classified according to the oxford classification of IgA nephropathy as mesangial hypercellularity, segmental glomerulosclerosis, endocapillary hypercellularity, or tubular atrophy/interstitial fibrosis.
Classification
IgA nephropathy may be classified according to its association to other pathology or by its histological features.
Classification by Associated Pathology
IgA nephropathy may be classified according to its association to other pathology (or lack there of) as follows:
Primary IgA Nephropathy
- When IgA nephropathy occurs alone, it is called "primary IgA nephropathy". It is thus not secondary to any chronic concomitant disease. Before the diagnosis of primary IgA nephropathy is made, secondary causes need to be ruled out.
Secondary IgA Nephropathy
- When IgA nephropathy occurs secondary to other chronic or systemic diseases, it is called “secondary IgA nephropathy”. Secondary causes of IgA nephropathy should be ruled out because secondary causes may alter the management plan and probably the prognosis too.
Classification by Histological Features
The pathologic classification of IgA nephropathy has been developed by the International IgA Nephropathy Network together with the Renal Pathology Society. This classification is called “The Oxford classification of IgA nephropathy”. This classification was done after a 5 years retrospective study on clinical data and kidney biopsies were obtained from 265 patients and multiple pathohistological analyses were done on the kidney specimens [1].
- IgAN is then histologically classified as:
- Mesangial hypercellularity
- Segmental glomerulosclerosis
- Endocapillary hypercellularity
- Tubular atrophy/interstitial fibrosis
| Histological Features | Description |
|---|---|
| Mesangial hypercellularity | In the glomerular mesangium, four or more mesangial cells are noted. |
| Segmental glomerulosclerosis | In the capillary lumen of the glomerulus, a higher density of cells is noted. |
| Endocapillary hypercellularity | Focal and not the whole obliteration of the capillary lumen by matrix material eads to the formation of adhesions or sclerosis. |
| Tubular atrophy/interstitial fibrosis | An estimated percentage of interstitial fibrosis or tubular atrophy is calculated. The more common feature represents the main pathology present. |
References
- ↑ Working Group of the International IgA Nephropathy Network and the Renal Pathology Society. Cattran DC, Coppo R, Cook HT, Feehally J, Roberts IS; et al. (2009). "The Oxford classification of IgA nephropathy: rationale, clinicopathological correlations, and classification". Kidney Int. 76 (5): 534–45. doi:10.1038/ki.2009.243. PMID 19571791.