Investigation of Lupus Nephritis Cases with Special Reference to Activity and Chronicity Indices

Background & Objectives: The International Society of Nephrology/ Renal Pathology Society (ISN/RPS) classification is based upon criteria which differentiate acute and chronic phases of Lupus Nephritis. Activity/Chronicity Index grants us a higher insight on the level of pathological lesions and treatment outcome by examining the reversibility of lesions .The present investigation was done in order to highlight the importance of activity and chronicity indices in the course of Lupus Nephritis. Materials & Methods: Seventy-three Kidney biopsy samples of Lupus Nephritis patients were examined. The information was recorded in a check-list and was then statistically analyzed. Results: Lupus Nephritis is importantly age-related, frequency of Lupus Nephritis increases with age until the age of ۴۰ years; ۲۱–۴۰ years being the most frequent among studied patients. A prominent decline was seen after the age of ۴۰. Regardless of age, the occurrence was more frequent in females. Class IV was most frequent in all ages and in both sexes. Both Activity and Chronicity scores were slightly higher in females. Activity Index was higher in ages of ۱۱ to ۳۰ years, whereas Chronicity Index was highest in ۴۱ to ۵۰ years of age. The highest Activity Index was reported in Class IV while the highest Chronicity Index was reported in Class V. The least Activity Index was shown in Class VI while Classes II and I had the lowest Chronicity Index. Endocapillary hypercellularity was the most frequent active lesion and tubular atrophy was the most frequent chronic lesion. It is noteworthy that fibrotic crescents were significantly less common among chronic lesions. Conclusion: Histopathological findings, clinical and para-clinical data could furnish more information on disease process, treatment, quality of life and mortality rate.

Keywords:

Lupus Nephritis , Activity Index , Chronicity Index , Histopathological features