C3 glomerulonephritis and autoimmune disease

more than a fortuitous association?

Mariam P Alexander, Fernando Custodio Fervenza, An S. De Vriese, Richard J H Smith, Samih H. Nasr, Lynn D. Cornell, Loren P. Herrera Hernandez, Yuzhou Zhang, Sanjeev M Sethi

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

C3 glomerulonephritis (C3GN) results from genetic or acquired dysregulation of the alternative complement pathway. A subset of patients may have clinical and biochemical characteristics compatible with an autoimmune disorder. We studied a cohort of 85 patients with confirmed C3GN (2007–2014), of which ten patients (3 male, 7 female; mean age 38.5 years) had an associated autoimmune disorder. All patients had abnormal ANA titers, 6 also had positive ds-DNA titers. At the time of presentation with C3GN, all 7 female patients had autoimmune-related presentations. Of the 3 male patients, only 1 patient had autoimmune-related presentations. Kidney biopsy showed predominantly mesangial proliferative or membranoproliferative glomerulonephritis. In 5 patients, the alternative pathway was evaluated. All had allele variants/polymorphisms associated with C3GN. One patient was also positive for C3Nefs. Treatment varied form conservative management to the use of prednisone alone or with cytotoxic therapy. Mean serum creatinine decreased from 2.0 to 1.4 mg/dL while proteinuria decreased from 2300 to 994 mg/24 h in 8 patients with follow-up. The study highlights the association between C3GN and autoimmune disorders, particularly in female patients. The study suggests that an autoimmune milieu may act as a trigger for the development of C3GN in genetically susceptible patients. Short-term prognosis of C3GN associated with autoimmune disorders appears excellent.

Original languageEnglish (US)
Pages (from-to)203-209
Number of pages7
JournalJournal of Nephrology
Volume29
Issue number2
DOIs
StatePublished - Apr 1 2016

Fingerprint

Glomerulonephritis
Autoimmune Diseases
Membranoproliferative Glomerulonephritis
Alternative Complement Pathway
Prednisone
Proteinuria
Creatinine
Alleles
Kidney
Biopsy

Keywords

  • ANA
  • Autoimmune disease
  • C3 glomerulonephritis
  • C3 glomerulopathy
  • ds-DNA

ASJC Scopus subject areas

  • Nephrology

Cite this

C3 glomerulonephritis and autoimmune disease : more than a fortuitous association? / Alexander, Mariam P; Fervenza, Fernando Custodio; De Vriese, An S.; Smith, Richard J H; Nasr, Samih H.; Cornell, Lynn D.; Herrera Hernandez, Loren P.; Zhang, Yuzhou; Sethi, Sanjeev M.

In: Journal of Nephrology, Vol. 29, No. 2, 01.04.2016, p. 203-209.

Research output: Contribution to journalArticle

Alexander, MP, Fervenza, FC, De Vriese, AS, Smith, RJH, Nasr, SH, Cornell, LD, Herrera Hernandez, LP, Zhang, Y & Sethi, SM 2016, 'C3 glomerulonephritis and autoimmune disease: more than a fortuitous association?', Journal of Nephrology, vol. 29, no. 2, pp. 203-209. https://doi.org/10.1007/s40620-015-0218-9
Alexander, Mariam P ; Fervenza, Fernando Custodio ; De Vriese, An S. ; Smith, Richard J H ; Nasr, Samih H. ; Cornell, Lynn D. ; Herrera Hernandez, Loren P. ; Zhang, Yuzhou ; Sethi, Sanjeev M. / C3 glomerulonephritis and autoimmune disease : more than a fortuitous association?. In: Journal of Nephrology. 2016 ; Vol. 29, No. 2. pp. 203-209.
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