Clinical and pathological features of 52 patients with glomerulonephritis with dominant C3
10.11817/j.issn.1672-7347.2024.230328
- VernacularTitle:C3沉积为主的肾小球肾炎52例临床与病理特征
- Author:
Jinying WEI
1
,
2
,
3
;
Yao HUANG
;
Shuguang YUAN
;
Xiaojun CHEN
;
Xiao FU
;
Zheng LI
;
Ying LI
;
Lin SUN
;
Hong LIU
;
Xuejing ZHU
Author Information
1. 中南大学湘雅二医院肾内科,长沙 410011
2. 中南大学肾病研究所,长沙 410011
3. 肾脏疾病与血液净化湖南省重点实验室,长沙 410011
- Keywords:
glomerulonephritis with dominant C3;
C3 glomerulopathy;
post-infectious glomerulonephritis;
renal pathology
- From:
Journal of Central South University(Medical Sciences)
2024;49(1):75-83
- CountryChina
- Language:Chinese
-
Abstract:
Objective:With the in-depth study of complement dysregulation,glomerulonephritis with dominant C3 has received increasing attention,with a variety of pathologic types and large differences in symptoms and prognosis between pathologic types.This study analyzes the clinical,pathological,and prognostic characteristics of different pathological types of glomerulonephritis with dominant C3,aiming to avoid misdiagnosis and missed diagnoses. Methods:The clinical,pathological,and follow-up data of 52 patients diagnosed as glomerulonephritis with dominant C3 by renal biopsy from June 2013 to October 2022 were retrospectively analyzed.According to the clinical feature and results of pathology,15 patients with post-infectious glomerulonephritis(PIGN)and 37 patients with of non-infectious glomerulonephritis(N-PIGN)were classified.N-PIGN subgroup analysis was performed,and 16 patients were assigned into a C3-alone-deposition group and 21 in a C3-dominant-deposition group,or 27 in a C3 glomerulopathy(C3G)group and 10 in a non-C3 nephropathy(N-C3G)group. Results:The PIGN group had lower creatinine values(84.60 μmol/L vs 179.62 μmol/L,P= 0.001),lower complement C3 values(0.36 g/L vs 0.74 g/L,P<0.001)at biopsy,and less severe pathological chronic lesions compared with the N-PIGN group.In the N-PIGN subgroup analysis,the C3-dominant-deposition group had higher creatinine values(235.30 μmol/L vs 106.70 μmol/L,P=0.004)and higher 24-hour urine protein values(4 025.62 mg vs 1 981.11 mg,P=0.037)than the C3-alone-deposition group.The prognosis of kidney in the PIGN group(P=0.049),the C3-alone-deposition group(P=0.017),and the C3G group(P=0.018)was better than that in the N-PIGN group,the C3-dominant-deposition group,and the N-C3G group,respectively. Conclusion:Glomerulonephritis with dominant C3 covers a variety of pathological types,and PIGN needs to be excluded before diagnosing C3G because of considerable overlap with atypical PIGN and C3G;in addition,the deposition of C1q complement under fluorescence microscope may indicate poor renal prognosis,and relevant diagnosis,treatment,and follow-up should be strengthened.
