Long-term outcome of anti-neutrophil cytoplasm antibody-associated glomerulonephritis: evaluation of the international histological classification and other prognostic factors

Abstract

We conclude that, in our cohort of patients, the international histological classification is predictive of renal outcome in AAGN, but did not appear to be additionally informative over other established prognostic factors in multivariate analysis. However, it may be of value to combine the current histological classification with other established parameters, such as TA and percentage normal glomeruli.

Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis in Mexican Population: Clinical Phenotype, Autoantibody Profile and Renal Characteristics

“…The most frequent renal histological class in our analysis was sclerotic, opposite to other single-center studies and multicentric clinical trials that have validated the histological classification, where sclerotic class was absent or very infrequent [7,22,24,25]. A study that analyzed the histopathological classification in 156 Australian patients reported 20 cases (17%) with sclerotic class, and concluded that the sclerotic patterns are the lesions more reliably identified by pathologists [26].…”

“…The presence of impaired renal function, and the low percentage of normal glomeruli (<25%) in our population are factors known to be associated with poor renal outcome [25,34,35].…”

“…Disease activity according to BVAS/GPA at diagnosis was 24 (16)(17)(18)(19)(20)(21)(22)(23)(24)(25), while FFS was 2 points (1-2). The most frequent clinical manifestations were general (98%), renal (80%), pulmonary (63%), ear, nose and throat (ENT) (58%).…”

S1 guidelines Diagnostics and treatment of ANCA-associated vasculitis

“…Nierenbiopsien liefern dagegen eine hohe diagnostische Ausbeute mit spezifischen Veränderun-gen (nekrotisierende Glomerulonephritis 85 %, Halbmondbildung 92 %) [2]. Die Ergebnisse der Nierenbiopsie haben zudem einen prognostischen Wert, da aktuell entzündliche (und therapeutische beeinflussbare) Veränderungen von bereits eingetretenen irreversiblen Schäden differenziert werden können, was Einfluss aufdie Wahl derTherapie habenkann [13,75,89,134,136,233,245]. Ebensokönnen Nierenfunktionseinschränkungen durch andere Begleiterkrankungen wie Diabetes mellitus oder arterielle Hypertonie abgegrenzt werden.…”

The Histopathological Classification of ANCA-associated Glomerulonephritis Comes of Age

“…These studies have varied in size and, to our knowledge, 7 studies have included over 100 biopsies 9,10,11,12,13,14,15,16 . The first 6 of these studies have been summarized in publications by Rahmattulla, et al 17 and van Daalen, et al 18 .…”