Case #16: H11-2873. C3 Glomerulonephritis.
A 30 year old female with hypertension for 9 years, presented with gross hematuria for one month and is found to have proteinuria of 3.25g/day(normal 0.01-0.15g/day) and a serum creatinine of 141µmol/L (normal 53-106) . A renal biopsy is performed.
Question #1: The photomicrograph highlights the mesangial proliferation noted in the glomerulus. Different pattern of injury have been described in patients with C3 glomerulonephritis including mesangial proliferation.
Question #2: The diagnosis of C3 glomerulopathy is supported by the presence of strong mesangial and to a lesser degree capillary staining for C3 on the immunofluorescence studies with negative immunoglobulins. The electron microscopy study shows mainly subendothelial non-organized dense deposits. Studies regarding C3 glomerulonephritis showed a EG CD46 mutation.
Hala Kfoury Kassouf is Associate Professor of Pathology at the King Saud University Hospital in Saudi Arabia.
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