The relationship between pathology grading and clinical grading for lupus nephritis in 59 cases / 中华风湿病学杂志

ABSTRACT

Objective To investigate the relevance of the clinical score and pathology score and assess two scoring system including the British Islet Lupus Assessment Group2004 (BILAG2004) and systemic lupus erythematosus disease activity index 2000 (SLEI)AI2000) by analyzing the biopsy results and related laboratory tests on lupus nephritis (LN). Methods Retrospective analyzed 59 cases of patients with renal biopsy. All biopsied tissues were scored based on the to ISN/RPS2003 lupus nephritis pathological typing standards. Meanwhile, respective index (AI), chronic Index (CI) and tubulointerstitial lesions (TIL) score were used to evaluate the activities of lupus nephritis and SLEDAI2000 and BILAG2004 were used to evaluate the clinical disease activity. The adssociation between pathological changes and disease activities was assessed. Results ①According to ISN/RPS2003 pathological type standard, among these 59 patients, type Ⅳ was the most common type,which accounted for 44.07 percent of all biopsied tissues. ② For those patients. With LN typeⅡ,Ⅲ Ⅳ, their SLEDAI2000 score and BILAG2004 renal biopsy AI was positively correlated (0<r<1, P <0.01), for those patients with LN type Ⅴ, their score BILAG2004 and kidney biopsy AI was positively correlated (0<r<1, P<0.05).③BILAG2004 score had stronger correlation with AI than SLEDAI2000. ④SLEDAI2000 score with AI in patients with type Ⅲ LN had the strongest association, followed by type Ⅱ. BILAG2004 score with AI in patients with type Ⅲ LN had the closet association, followed by type Ⅳ. ⑤ BII,AG2004 score, SLEDAI2000 score and CI, TIL had no significant association in all patients groups (P>0.05). Conclusion BILAG2004 score and SLEDAI2000 scoring system can be used to assess the disease pathology activity of patients with lupus nephritis. The study has found that BILAG2004 scoring system is superior to SLEDAI2000 score system for the assessment of LN patients on pathological activities, especially for with severe LN patients. As a non-invasive method of assessment, BILAG2004 score system is better than SLEDAI2000 score system in guiding clinical treatment.