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Analyses of Proteinuria, Renal Infiltration of Leukocytes, and Renal Deposition of Proteins in Lupus-prone MRL/lpr Mice
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Clinicopathological Significance and Renal Outcomes of Light Microscopic Patterns in Complement Component 3

Asif Sadiq Wani1, Zafirah Zahir2, Amit Gupta1

  • 1Department of Nephrology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

Nephron
|March 11, 2020
PubMed

Insights

Complement component 3 glomerulopathy (C3G) light microscopy patterns show varied clinicopathological profiles but similar renal outcomes. Glomerulosclerosis and interstitial fibrosis predict poor prognosis in C3G patients.

Area of Science:

  • Nephrology
  • Pathology
  • Immunology

Background:

  • Complement component 3 glomerulopathy (C3G) is diagnosed by dominant C3 immunostaining in glomeruli.
  • Current electron microscopy subtyping has limitations.
  • This study explores light microscopy (LM) patterns in C3G.

Purpose of the Study:

  • To classify C3G based on LM patterns.
  • To correlate these patterns with clinicopathological findings and treatment outcomes.
  • To identify predictors of end-stage renal disease (ESRD) in C3G.

Main Methods:

  • C3G biopsies were categorized into four LM patterns: membranoproliferative GN (MPGN), mesangial proliferative GN (MesPGN), diffuse proliferative GN (DPGN), and crescentic GN (CrGN).
  • Clinicopathological profiles, treatment responses, and renal survival were compared across patterns.
  • Cox proportional hazards models identified ESRD predictors.

Main Results:

  • 162 biopsies revealed 83 MPGN, 36 DPGN, 22 MesPGN, and 21 CrGN cases.
  • Immunosuppression was given to 48% of patients, with a 32.7% overall remission rate.
  • Progression to ESRD was associated with older age, advanced renal failure, glomerulosclerosis, and interstitial fibrosis/tubular atrophy.

Conclusions:

  • LM patterns of C3G exhibit distinct clinicopathological features but similar renal outcomes.
  • Glomerulosclerosis and interstitial fibrosis are significant indicators of poor prognosis.
  • MesPGN, alongside CrGN, can represent severe C3G presentations.
Abstract

Keywords:
C3 glomerulonephritisComplement component 3 glomerulopathyDense deposit diseaseLight microscopic patterns

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