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Complement System and C4d expression in cases of Membranous nephropathy.

Fabiano Bichuette Custódio1, Crislaine Aparecida da Silva2, Fernanda Rodrigues Helmo2

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Membranous nephropathy (MN) involves complement system activation. C4d deposition, indicating complement involvement, correlates with tubulointerstitial fibrosis but not clinical prognosis in MN patients.

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Area of Science:

  • Nephrology
  • Immunology
  • Pathology

Background:

  • Membranous nephropathy (MN) is a primary cause of nephrotic syndrome.
  • The complement system is integral to MN pathogenesis.

Purpose of the Study:

  • Investigate complement pathway activation in MN.
  • Correlate C4d presence with clinical and histological severity.

Main Methods:

  • Analyzed 69 renal biopsies with MN.
  • Assessed C1q via immunofluorescence and C4d via immunohistochemistry.
  • Collected clinical and epidemiological data.

Main Results:

  • C4d was present in 84% of cases; C1q in 17%.
  • C4d deposition was linked to increased interstitial fibrosis.
  • All complement pathways (classical, lectin, alternative) may be activated in MN.

Conclusions:

  • C4d is associated with severe tubulointerstitial lesions in MN.
  • C4d presence does not predict clinical prognosis.
  • C4d and C1q findings suggest involvement of all complement pathways, particularly the lectin pathway.