The clinical manifestations of children with endocapillary proliferative glomerulonephritis with isolated C3 deposition
10.3760/cma.j.issn.2095-428X.2016.05.011
- VernacularTitle:仅有补体 C3沉积的儿童毛细血管内增生性肾炎临床分析
- Author:
Nan ZHOU
;
Ying SHEN
;
Chunju ZHOU
;
Guiju ZHANG
;
Qun MENG
;
Jianfeng FAN
;
Qiang SUN
;
Zhi CHEN
;
Xiaorong LIU
- Publication Type:Journal Article
- Keywords:
Complement 3;
Endocapillary proliferative glomerulonephritis;
Streptococcus infection
- From:
Chinese Journal of Applied Clinical Pediatrics
2016;31(5):363-366
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the patients' clinical characteristics and prognosis when only C3 deposition exists in endocapillary proliferative glomerulonephritis and try to understand deeply the role of C3 in kidney damage deeply. Methods The patients who were diagnosed with endocapillary proliferative glomerulonephritis but only had C3 deposited in immunofluorescence(to avoid false positive,C3≥2 ﹢ was included)were selected from Beijing Children's Hospital Affiliated to Capital Medical University during November 2010 to October 2014. Their clinical manifestations,la-boratory examinations,treatments,prognosis,and pathological changes were analyzed,and literature review was performed. Their clinical characteristics and prognosis were summarized. Results There were 11 patients diagnosed with endocapil-lary proliferative glomerulonephritis which had only C3 deposition(≥2 ﹢ ). Nine of them had onset with acute nephritis syndrome(81. 8% ),and 2 cases presented recurrent paroxysmal gross hematuria(18. 2% ). Seven cases were diagnosed with acute post streptococcal glomerulonephritis(63. 6% ). Eleven cases' clinical manifestations were relatively severe, and the complement C3 was significantly lower than the normal(100. 0% ). Their light microscope showed capillary proli-ferative glomerulonephritis,and the electron microscope showed the immune complexes were deposited in the endothelium,the epithelium or the mesangial area. The patients received corresponding treatment respectively,and all the patients had good prognosis during following up of 7 months up to 39 months. Conclusions Streptococcus infection is a common cause in endocapillary proliferative glomerulonephritis with only C3 deposition. The clinical manifestations of some children are similar to post streptococcal glomerulonephritis but relatively severe. Only deposition of C3 without IgG may be involved in another complement activation mechanism.
