Table 1 Two proposed criteria for IgG4-TIN by the Mayo Clinic and JSN
From: Evaluation of diagnostic criteria for IgG4-related tubulointerstitial nephritis
Criterion | The Mayo Clinic criteria | JSN criteria |
|---|---|---|
Histology | Plasma cell-rich TIN with >10 IgG4+ plasma cells/HPF field in the most concentrated field (mandatory criterion) | a. Dense lymphoplasmacytic infiltrate with >10 IgG4+ plasma cells/HPF and/or IgG4/IgG+ plasma cell ratio of >40Â % |
| Â | TBM immune complex deposits by immunofluorescence, immunohistochemistry, and/or electron microscopy | b. Characteristic storiform fibrosis |
Imaging | Small peripheral low-attenuation cortical nodules, round or wedge-shapped lesions, or diffuse patchy involvement | Multiple low-density lesions on enhanced CT, diffuse kidney enlargement, hypovascular solitary nodule, hypertrophic lesion of the renal pelvic wall |
Serology | Elevated serum IgG4 or total IgG level | Elevated serum IgG4 or total IgG level |
Clinical features | None | Clinical or laboratory evidence of kidney damage |
Other organ involvement | Characteristic findings of IgG4-RD in other organs | Characteristic findings of IgG4-RD in other organs |
Definite IgG4-TIN | The histologic feature and at least one other feature from imaging, serology or other organ involvement | The histologic feature (a and b) and at least two of other features from imaging, serology or other organ involvement |