A patient with IgA nephropathy has Oxford MEST-C pathological scoring. The 'E' lesion in MEST-C that predicts faster progression to ESRD refers to:

• A Endocapillary hypercellularity ✓
• B Extracapillary proliferation (crescents)
• C Endothelial activation markers
• D Electron-dense deposits in endothelium

Explanation

The Oxford Classification (MEST-C) for IgA nephropathy scores four independent predictors of progression: Mesangial hypercellularity (M), Endocapillary hypercellularity (E), Segmental sclerosis (S), Tubular atrophy/interstitial fibrosis (T), and Crescents (C). The 'E' lesion refers specifically to endocapillary hypercellularity (increased cellularity within glomerular capillaries due to leucocyte infiltration and endothelial cell proliferation). Crescents are represented by 'C.' E score ≥1 is an independent predictor of poor renal outcome and may respond to immunosuppression.

Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.