Donadio et al developed a histologic scoring system for evaluating renal biopsies from patients with IgA nephropathy. The authors are from the Mayo Clinic.
Component indices:
(1) glomeruli
(2) tubules and interstitium
(3) vascular
Glomerular features:
(1) mesangial hypercellularity
(2) matrix increase
(3) glomerular sclerosis
(4) capillary narrowing and/or disruption
(5) cellular crescents
(6) fibrous adhesions
Tubular and interstitial (tubulointerstitial) features:
(1) tubular dilatation
(2) vacuolization
(3) atrophy
(4) erythrocyte casts
(5) proteinaceous casts
(6) interstitial cellular infiltration, edema and/or fibrosis
Vascular features:
(1) interlobular artery sclerosis
(2) interlobular artery hyalinization
(3) interlobular artery thickening
(4) interlobular medial hypertrophy
(5) arteriolar sclerosis
(6) arteriolar hyalinization
(7) arteriolar thickening
Histologic Change |
Points |
no change |
0 |
mild change |
1 |
moderate change |
2 |
severe change |
3 |
glomerular index =
= SUM(points for all 6 parameters)
tubulointerstitial index =
= SUM(points for all 6 parameters)
vascular index =
= SUM(points for all 7 parameters)
Interpretation:
• minimal indices: 0
• maximal glomerular index: 18
• maximal tubulointerstitial index: 18
• maximal vascular index: 21
• The higher the index, the greater the extent of involvement.
Specialty: Nephrology, Clinical Laboratory, Immunology/Rheumatology