Frequency of histopathological patterns of Lupus Nephritis according to WHO classification – Report from a tertiary referral centre from Central Lahore
Histopathological patterns of Lupus Nephritis according to WHO classification
Background: Renal involvement in Systemic Lupus Erythematosus (Lupus Nephritis) carries high morbidity and mortality. It is important to classify Lupus Nephritis to ensure appropriate management for improved long-term prognosis. This study was conducted to determine the frequency of histopathological patterns of lupus nephritis according to World Health Organization (WHO) classification on renal biopsy in patients presenting at a Tertiary referral centre in Central Lahore.
Patients and methods: This cross-sectional study was done at Division of Rheumatology, Fatima Memorial Hospital, Lahore from January 2017 till July 2017. Eighty-three consecutive patients, fulfilling 2012 Systemic Lupus International Collaborating Clinics (SLICC) classification criteria for Systemic Lupus Erythematosus (SLE), and having evidence of nephritis were enrolled. An informed consent was obtained from the subjects to include their data in the study. Renal biopsy was done by the same Consultant Nephrologist and biopsy specimens sent to the Pathology Department were reported by the same Consultant Pathologist. Patterns of Lupus Nephritis according to WHO classification criteria were recorded on a pre-designed proforma. Data was analysed using SPSS version 22.0 for Windows. Frequency of each class of nephritis was calculated.
Results: Total of 83 diagnosed patients were evaluated. Majority of patients (69%) were between 31-50 years (n=57). Mean age was 43.76±4.74 years. There were 49 females (59.03%). Patterns of Lupus Nephritis according to WHO classification showed that 9.63% (n=8) had Class I, 21.68% (n=18) Class II, 26.50% (n=22) Class III, 32.53% (n=27) Class IV, 6.02% (n=5) Class V and 3.61% (n=3) had Class VI.
Conclusion: The frequency of WHO Class III and Class IV is high among patients with Lupus Nephritis. So, every patient who presents with nephritis should be sorted out for class of the disease in order to start early treatment to limit renal failure.