Bomback Andrew S
Department of Medicine, Division of Nephrology, Columbia University College of Physicians and Surgeons, 622 West 168th Street, PH 4-124, New York, NY 10032, USA.
Rheum Dis Clin North Am. 2018 Nov;44(4):561-569. doi: 10.1016/j.rdc.2018.06.003. Epub 2018 Sep 7.
Most of the attention paid to lupus nephritis, in the medical literature and in clinical trials, has primarily focused on proliferative forms of lupus nephritis (class III and IV lesions), but with lower thresholds to biopsy and rebiopsy patients with lupus, clinicians are encountering more cases with purely mesangial disease (class I and II) or membranous nephropathy patterns (class V). These lesions often will be associated with milder disease courses but still require dedicated follow-up by a nephrologist and focused therapeutic strategies that, at times, will include immunosuppression.
在医学文献和临床试验中,对狼疮性肾炎的关注大多主要集中在增殖性狼疮性肾炎(III 类和 IV 类病变)上,但由于对狼疮患者进行活检和重复活检的阈值降低,临床医生遇到了更多纯系膜疾病(I 类和 II 类)或膜性肾病模式(V 类)的病例。这些病变通常与较轻的病程相关,但仍需要肾病专家进行专门的随访以及有针对性的治疗策略,有时这些策略将包括免疫抑制。