A 4-year-old girl with systemic lupus erythematosus presents with nephrotic syndrome (proteinuria 5.8 g/day, serum albumin 2.0 g/dL), hematuria, and declining renal function. Immunofluorescence shows 'full house' pattern. Serum C3 and C4 are significantly depressed. Which of the following WHO lupus nephritis classes is associated with the worst long-term renal prognosis if untreated?
- A)Class IV (diffuse proliferative)GABARITO
- B)Class II (mesangial proliferative)
- C)Class III/V overlap
- D)Class III (focal proliferative)
- E)Class V (membranous)
Explicação
Class IV lupus nephritis (diffuse proliferative) has the worst prognosis with highest risk of progression to ESRD without aggressive immunosuppressive therapy. It is the most severe and common form, characterized by >50% glomerular involvement, nephrotic prote... Ver explicação completa e trilha adaptativa →