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Glomerular C4d deposition in proliferative glomerular diseases

Sarojini Raman1, Pallavi Mishra1, Ansuman Panigrahi2

  • 1Department of Pathology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha, India.

Indian Journal of Pathology & Microbiology
|January 12, 2021
PubMed

Insights

C4d deposition is common in proliferative glomerular diseases, particularly associated with IgG and IgM staining. This finding aids in understanding complement pathways and disease pathogenesis.

Area of Science:

  • Nephrology
  • Immunology
  • Pathology

Background:

  • Proliferative glomerular diseases involve complex complement pathways.
  • Immunohistochemical evaluation of C4d aids in understanding renal pathology.
  • C4d deposition is a marker of complement activation in kidney diseases.

Purpose of the Study:

  • To evaluate C4d expression in native renal biopsies of proliferative glomerular diseases.
  • To investigate the role of complement pathways in these diseases.
  • To correlate C4d with histological, clinical, and immunological markers.

Main Methods:

  • Cross-sectional study of 107 native renal biopsies diagnosed with proliferative glomerular diseases.
  • Immunohistochemistry using polyclonal anti-human C4d antibody.
  • Classification of patients based on glomerular C4d deposition (positive/negative).

Main Results:

  • Overall C4d positivity was 80.4% in proliferative glomerular diseases.
  • C4d positivity ranged from 60.0% in C3 glomerulonephritis to 92.9% in membranoproliferative glomerulonephritis.
  • Glomerular IgG and IgM staining were significantly associated with C4d positivity (aOR: 5.86 and 3.90, respectively).

Conclusions:

  • C4d staining, alongside immunoglobulin markers (IgG, IgM), helps delineate complement activation pathways.
  • This approach aids in understanding the pathogenesis of glomerular diseases.
  • C4d evaluation is a valuable tool in diagnosing and characterizing proliferative glomerular diseases.
Abstract

Keywords:
C4d positivitycomplement proteinsimmunoglobulin markersproliferative glomerular diseaserenal biopsy

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