The predictive value of peritubular capillaries C3d deposition in IgA glomerulonephritis

Abstract

The IgA glomerulonephritis (IgAGN) is one of the most common primary glomerulonephritis and has a variable and difficult to predict evolution toward the end‐stage nephrosclerosis. The deposition of C3d complement component in peritubular capillaries (PTCs) indicates a variant type of acute rejection while C3d deposition in primary glomerulonephritis (GN) is poorly documented. The aim of this study is to examine C3d expression in peritubular capillaries (PTCs) as a predictive marker and its correlation with the severity of renal injury in IgA glomerulonephritis. Polyclonal FITC conjugated rabbit anti‐human C3c and C3d antibodies were used for direct immunofluorescent evaluation of the C3c and C3d deposits in 24 kidney biopsies with IgA glomerulonephritis. The study revealed that the C3d deposits in peritubular capillaries were associated with known predictors for rapid progression of IgAGN: glomerular sclerosis (63.6%), atrophic tubules (90,9%) and interstitial sclerosis (81,8%). The intensity of the C3c glomerular immunofluorescent deposits was related with active lesions. Thus, the predictive value of C3d deposition on PTCs in IgAGN is worth to be taken into consideration as an unfavorable outcome of the disease and request further long run investigations.

Renal Tubular Complement 3 Deposition in Children with Primary Nephrotic Syndrome

“…Glomerular capillary C3d deposition may also serve as a new marker in the pathological diagnosis of MN at stage I, in patients who are treated with glucocorticoids. In recent years, various studies have explored the C3 deposition in glomerular capillaries and arterioles in association with IgAN and have revealed that peritubular capillary C3 deposition may be used as a predictor of a poor prognosis, while C3 deposition in the renal arterioles may be considered a marker of atherosclerosis [ 20 , 22 ]. In addition, C3 deposition in the glomerular capsule and/or arterioles is related to the clinical outcome of IgAN [ 17 ].…”

Useful indicators for performing renal biopsy in adult patients with isolated microscopic haematuria

“…It was reported that the serum levels of IgA are notably increased in 1/3 to 1/2 of the patients with IgAN (11–14). Although the serum C3 level tends to decrease in the active stage of CGN, it is generally considered that serum C3 level shows a normal range in patients with IgAN (15). Therefore, it is implied that the elevation of serum IgA level and serum IgA to C3 (IgA/C3) ratio are valuable indexes for predicting IgAN.…”

“…IgAN (15). Therefore, it is implied that the elevation of serum IgA level and serum IgA to C3 (IgA/C3) ratio are valuable indexes for predicting IgAN.…”

Glomerulonefritis rápidamente progresiva asociada a ANCA en un paciente con nefropatía por IgA, reporte de caso

“…El depósito de C3 y C4, en las biopsias renales de NIgA, sugiere la activación de la vía alternativa y de las lectinas. Desde el punto de vista clínico, el depósito de C4d en el mesangio y C3d en células peritubulares se ha asociado a formas agresivas de la enfermedad 21,22 . Ya se han evaluado bloqueadores del complemento en pacientes con nefritis lúpica y vasculitis ANCA e incluso se reportó el uso de eculizumab en un paciente NIgA refractaria a esteroide, ciclofosfamida y plasmaféresis [23][24][25] .…”