Table 1.

Classification of GN

Pathogenic TypeSpecific Disease EntityPattern of Injury: Focal or DiffuseScores or Class
Immune-complex GNaIgA nephropathy, IgA vasculitis, lupus nephritis, infection-related GN, fibrillary GN with polyclonal Ig depositsMesangial, endocapillary, exudative, membranoproliferative, necrotizing, crescentic, sclerosing, or multiplebOxford/MEST scores for IgA nephropathy
ISN/RPS class for lupus nephritis
Pauci-immune GNMPO-ANCA GN, proteinase 3-ANCA GN, ANCA-negative GNNecrotizing, crescentic, sclerosing, or multiplebFocal, crescentic, mixed, or sclerosing class (Berden/EUVAS class)
Anti-GBM GNAnti-GBM GNNecrotizing, crescentic, sclerosing, or mixedb
Monoclonal Ig GNaMonoclonal Ig deposition disease, proliferative GN with monoclonal Ig deposits, immunotactoid glomerulopathy, fibrillary GN with monoclonal Ig depositsMesangial, endocapillary, exudative, membranoproliferative, necrotizing, crescentic, sclerosing, or multipleb
C3 glomerulopathyC3 GN, dense deposit diseaseMesangial, endocapillary, exudative, membranoproliferative, necrotizing, crescentic, sclerosing, or multipleb
  • MEST, mesangial hypercellularity, endocapillary hypercellularity, segmental sclerosis, interstitial fibrosis/tubular atrophy; ISN/RPS, International Society of Nephrology/Renal Pathology Society; EUVAS, European vasculitis study group.

  • a Some pathologists use the terms immune complex–mediated GN, monoclonal Ig–associated GN, etc. It is up to the discretion of the pathologist to use these terms.

  • b Multiple patterns include two or more patterns of injury. The patterns should be stated (e.g., focal mesangial proliferative, crescentic, and sclerosing or diffuse necrotizing, crescentic, and sclerosing).