Lupus Nephritis Classification — SCE Rheumatology MCQ

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ModerateSLE & Antiphospholipid SyndromeLupus Nephritis ClassificationSCE Rheumatology

A 45-year-old woman with SLE presents with painless haematuria and proteinuria (1.8 g/day). Anti-dsDNA is elevated and C3 is low. Renal biopsy shows mesangial hypercellularity with immune complex deposition confined to the mesangium. What ISN/RPS class of lupus nephritis is this?

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Correct answer: E — Class II

ISN/RPS Class II mesangial proliferative lupus nephritis is characterised by mesangial hypercellularity with immune complex deposition limited to the mesangium on light microscopy and immunofluorescence. It typically presents with microscopic haematuria and mild proteinuria. Treatment is usually conservative (Hydroxychloroquine, monitoring) unless there is progression to a higher class. Classes III and IV involve subendothelial deposits and require aggressive immunosuppression. Regular monitoring is essential as class transformation can occur.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/musculoskeletal-conditions