Lee’s classification of IgA nephropathy

Grade of IgA nephropathy: IgA nephropathy is classified into five grades: (1) IgA nephropathy grade I: patients with iga nephropathy have normal glomeruli, occasional mild thylakoid widening (segmental) with or without cellular hyperplasia, and no changes in tubules and interstitium, which is the lightest type in Lee’s classification. (ii) Lee grade II iga nephropathy: In this stage, the glomeruli show focal proliferation and sclerosis (<50%), with rare small crescents, and no damage to the tubules and interstitium. In this stage, the lesions are more severe compared to the first stage, with focal damage under light microscopy, and the lesions affect a few glomeruli (foci) and some of the lobules (segments) of the glomeruli. (C) iga nephropathy Lee classification grade III: In this case, the patient's glomeruli show diffuse thylakoid accretion and widening (occasional focal segments), with occasional small crescents; tubular and interstitial changes show focal interstitial edema, with occasional cellular infiltration, and rare renal tubular atrophy. Cellular infiltration can then lead to an inflammatory response, at which point, if left unchecked, the functional renal cells undergo phenotypic transformation and release a range of nephrotoxic factors in the course of the inflammatory response. The area of glomerulosclerosis will increase, tubular atrophy will also increase, and interstitial renal vascular fibrosis will also occur. (d) IgA Nephropathy Lee Class IV: Glomerular lesions show severe diffuse thylakoid proliferation and sclerosis, with partial or total glomerulosclerosis and visible crescents (<45%). Renal tubules are atrophic with interstitial infiltration and occasional interstitial foam cells. Take crescent body as an example in this classification: crescent body in this type is close to 50%, it can be said that if patients do not pay attention to it, it is very likely to reach this number, and research shows that when the crescent body exceeds more than 50% of the total number of glomeruli, it is crescentic nephritis (or crescentic iga nephropathy), which is the most common type II-immune complex crescentic nephritis in China, except lupus nephritis, and the severity of it is self-evident. Its seriousness is self-evident. (v) IgA nephropathy Lee classification grade V: the nature of glomerular lesions is similar to grade IV, but more serious, glomerular crescent formation >45%; tubular and interstitial lesions are similar to grade IV, but more serious. The lesions in this stage of IgA nephropathy are the most serious among IgA nephropathies, so the treatment is also the most difficult. iga nephropathy treatment measures are no different from the treatment of grade IV, only that it needs a more rigorous treatment program, and maybe it will be relatively longer in the treatment time.