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C3 glomerulonephritis associated with ANCA positivity: a case report
Ling Li1, Li-Qin Liu2, Ying-Ying Yang1
1Renal Division, Department of Medicine, West China Hospital of Sichuan University, 610041, Chengdu, China.
BMC Nephrology
|April 22, 2021
Summary
C3 glomerulopathy (C3G) can rarely present with membranous nephropathy-like lesions and anti-neutrophil cytoplasmic antibodies (ANCA) positivity. This case highlights a rare C3G variant requiring further investigation for optimal treatment strategies.
Area of Science:
- Nephrology
- Immunology
- Pathology
Background:
- C3 glomerulopathy (C3G) is a kidney disease characterized by C3 deposits without significant immunoglobulin, encompassing dense deposit disease and C3 glomerulonephritis (C3GN).
- C3GN typically presents with membranoproliferative or mesangial proliferative patterns, with membranous nephropathy (MN)-like lesions being rare.
- Anti-neutrophil cytoplasmic antibodies (ANCA) positivity is seldom reported in C3GN.
Observation:
- A 68-year-old woman presented with elevated creatinine, proteinuria, and hematuria.
- Renal biopsy revealed C3GN with MN-like features, including subepithelial electron-dense deposits and thickened glomerular basement membranes.
- The patient tested positive for ANCA (p-ANCA, elevated PR3 and MPO antibodies).
Findings:
- The patient exhibited a rare presentation of C3GN with both MN-like glomerular lesions and ANCA positivity.
- Treatment with corticosteroids and cyclophosphamide led to improved renal function.
Implications:
- This case underscores the diverse presentations of C3GN, including rare MN-like patterns with ANCA positivity.
- Further research is needed to understand the clinicopathologic features and optimal treatments for C3GN with ANCA positivity.
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