Oxford MEST-C (IgA Nephropathy Biopsy)
The Oxford classification (MEST-C) of an IgA nephropathy biopsy.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- M - Mesangial hypercellularity
- M1 — mesangial hypercellularity score above 0.5
- E - Endocapillary hypercellularity
- E0 — absent
- S - Segmental glomerulosclerosis
- S1 — present
- T - Tubular atrophy and interstitial fibrosis
- T1 — 26 to 50 percent of cortical area
- C - Cellular or fibrocellular crescents
- C0 — no crescents
Result: MEST-C M1 E0 S1 T1 C0.
The tool opens with these values already filled in. Replace them with your own.
What the result means
- M
- Mesangial hypercellularity. M0 at a mesangial score of 0.5 or below, M1 above 0.5. Taken from the score, not a percentage of glomeruli, which sources render inconsistently at exactly 50 percent.
- E
- Endocapillary hypercellularity. E0 absent, E1 present in any glomerulus.
- S
- Segmental glomerulosclerosis. S0 absent, S1 present.
- T
- Tubular atrophy and interstitial fibrosis as a share of cortical area. T0 0 to 25 percent, T1 26 to 50 percent, T2 above 50 percent.
- C
- Cellular or fibrocellular crescents as a share of glomeruli. C0 none, C1 above 0 and below 25 percent, C2 25 percent or more.
- Not summed
- Reported as the five scores side by side. The summed 0 to 7 grading is a research proposal, not the standard biopsy report.
What you enter
- M - Mesangial hypercellularity.
- E - Endocapillary hypercellularity.
- S - Segmental glomerulosclerosis.
- T - Tubular atrophy and interstitial fibrosis.
- C - Cellular or fibrocellular crescents.
Full field descriptions
- M - Mesangial hypercellularity. Scored from the mesangial hypercellularity score, not from a percentage of glomeruli: sources reproducing it as a percentage disagree about the boundary at exactly 50 percent, while the score threshold of 0.5 is consistent. [M0 — mesangial hypercellularity score at or below 0.5; M1 — mesangial hypercellularity score above 0.5]
- E - Endocapillary hypercellularity. Present in any glomerulus is enough for E1. [E0 — absent; E1 — present in any glomerulus]
- S - Segmental glomerulosclerosis. Any segmental sclerosis or adhesion. [S0 — absent; S1 — present]
- T - Tubular atrophy and interstitial fibrosis. Estimated as a share of the cortical area, not of glomeruli. [T0 — 0 to 25 percent of cortical area; T1 — 26 to 50 percent of cortical area; T2 — above 50 percent of cortical area]
- C - Cellular or fibrocellular crescents. Added by the 2016 update. Scored on the glomeruli sampled, so a biopsy with few glomeruli can miss focal crescents. [C0 — no crescents; C1 — crescents in above 0 and below 25 percent of glomeruli; C2 — crescents in 25 percent or more of glomeruli]
How this is calculated
Cattran DC, Coppo R, Cook HT, et al. The Oxford classification of IgA nephropathy: rationale, clinicopathological correlations, and classification. Kidney Int. 2009;76(5):534-545. C lesion added in Trimarchi H, Barratt J, Cattran DC, et al. Kidney Int. 2017;91(5):1014-1021. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.