Mayo Clinic/Renal Pathology Society Consensus Report on Pathologic Classification, Diagnosis, and Reporting of GN
Mayo Clinic/Renal Pathology Society Consensus Report on Pathologic Classification, Diagnosis, and Reporting of GN
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DOI：
10.1681/asn.2015060612
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发表时间：
2016-05-01
影响因子：
13.6
通讯作者：
Fervenza, Fernando C.
中科院分区：
文献类型：
--
作者：
Sethi, Sanjeev;Haas, Mark;Fervenza, Fernando C.
2015年2月20日，肾脏病理学家和肾病学家举行会议，建立基于病因/病机的GN分类和诊断系统，主要目的是规范GN的肾活检报告。根据病因/发病机制，GN可分为免疫复合型GN、少免疫型GN、抗肾小球基底膜GN、单克隆性Ig GN和C3肾小球病变五种类型。基于发病机制的分类构成了肾活检报告的基础。为了使报告标准化，诊断由一次诊断和二次诊断组成。初步诊断应包括疾病实体/致病类型(如果疾病实体未知)，其次是损伤模式(可能存在混合模式)；疾病实体的评分/级别/类别，如IgA肾病、狼疮性肾炎和ANCA GN；以及本文详细说明的其他特征。不建议将模式诊断作为唯一的首要诊断。二次诊断应单独报告，并包括不构成一次诊断的合并病变。还提供了报告格式、光学显微镜、免疫荧光显微镜、电子显微镜和辅助研究的指南。总之，这份共识报告强调了基于发病机制的肾小球肾炎的分类，并为肾炎的标准化报告提供了指南。
Renal pathologists and nephrologists met on February 20, 2015 to establish an etiology/pathogenesis-based system for classification and diagnosis of GN, with a major aim of standardizing the kidney biopsy report of GN. On the basis of etiology/pathogenesis, GN is classified into the following five pathogenic types, each with specific disease entities: immune-complex GN, pauci-immune GN, antiglomerular basement membrane GN, monoclonal Ig GN, and C3 glomerulopathy. The pathogenesis based classification forms the basis of the kidney biopsy report. To standardize the report, the diagnosis consists of a primary diagnosis and a secondary diagnosis. The primary diagnosis should include the disease entity/pathogenic type (if disease entity is not known) followed in order by pattern of injury (mixed patterns may be present); score/grade/class for disease entities, such as IgA nephropathy, lupus nephritis, and ANCA GN; and additional features as detailed herein. A pattern diagnosis as the sole primary diagnosis is not recommended. Secondary diagnoses should be reported separately and include coexisting lesions that do not form the primary diagnosis. Guidelines for the report format, light microscopy, immunofluorescence microscopy, electron microscopy, and ancillary studies are also provided. In summary, this consensus report emphasizes a pathogenesis-based classification of GN and provides guidelines for the standardized reporting of GN.