关于系统性红斑狼疮与狼疮肾炎诊断的研究进展

    Controversies of systematic lupus erythmatousus and lupus nephritis

    • 摘要: 系统性红斑狼疮(systemic lupus erythematosus,SLE)是以多系统受累和多种自身抗体存在为主要特点的慢性自身免疫性疾病,常侵袭肾脏。SLE分类标准自1971至2019年多次因临床表现及实验室指标上的新发现而更新。新分类标准的特异性及灵敏性在修改后均有提高,但其依旧不是临床诊断标准。值得关注的是,肾组织病理对SLE分类的价值曾被多次否定,而近年其又重返专家视野。由于目前全球缺乏对狼疮肾炎(lupus nephritis,LN)病理的共识,肾活检标准当前备受质疑。本文将描述狼疮肾炎的“狼疮样”病理表现及探讨病理应用于LN的新进展。

       

      Abstract: Systemic lupus erythematosus (SLE) is a chronic autoimmune renal disease with multisystem involvement and multiple autoantibody presenting. The SLE classification criteria have been updated several times from 1971 to 2019 for new findings of clinical manifestations and laboratory parameters. Though not clinical diagnostic criteria, the specificity and sensitivity of the new classification criteria have improved after revision. It is worth noting that the classification value of renal histopathology to SLE has been neglected previously many times. However, in recent years it has regained the attention of experts. Due to a lack of global consensus on the pathology of lupus nephritis (LN), renal biopsy standards are currently questioned. ‘Lupus-like’ pathologic features and recent advances were summarized for diagnosing LN.

       

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