A rare co-existence of celiac disease and C3 glomerulopathy

Glomerulonephritis associated with celiac disease (CD) is rarely reported. Here we report a rare case of nephrotic syndrome associated with C3 glomerulopathy (C3G) in a patient with CD. A 19-year-old female with bilateral leg swelling and hypoalbuminemia was referred with an initial diagnosis of nephrotic syndrome. She had also abdominal pain and diarrhea. First a duodenal biopsy confirmed the diagnosis as CD. Nephrotic range proteinuria was detected so then a percutaneous renal biopsy was performed. Renal biopsy revealed membranoproliferative glomerulonephritis (MPGN) with C3 staining. Introduction of a gluten-free diet, ramipril, steroid and mycophenolic acid ameliorated clinical and laboratory parameters at three years follow up. Edema and hypoalbuminemia are common sharing clinical and laboratory parameters presented in not only patients with CD but also with glomerulonephritis. Urine analysis is very important in patients with CD to detect proteinuria. It is important to keep the possible link between CD and glomerulonephritis in mind for clinicians when working up a patient with diarrhea and nephrotic syndrome.