C1q nephropathy presenting as rapidly progressive crescentic glomerulonephritis.
Document Type
Article
Publication Date
9-1-2000
Identifier
DOI: 10.1007/s004670050056
Abstract
C1q nephropathy is an immune complex glomerulonephritis defined by the presence of mesangial immunoglobulins and complement deposits, most notably C1q, and the absence of clinical and laboratory evidence of systemic lupus erythematosus. Histology in C1q nephropathy is characterized by a slight to severe increase in mesangial cellularity and matrix, with or without segmental sclerosis. C1q nephropathy usually presents with nephrotic-range proteinuria in older children and young adults, and has a poor response to steroids. Patients may have decreased creatinine clearance at presentation, but progression to end-stage renal disease (ESRD) is slow. Severe crescentic glomerulonephritis has not been reported in C1q nephropathy. We describe a 3-year-old Hispanic girl who presented with renal insufficiency. Kidney biopsy showed C1q nephropathy with severe crescentic glomerulonephritis. The clinical and serological evaluation ruled out systemic lupus erythematosus or other immunological or infectious etiologies. In spite of immunosuppressive therapy, she progressed to ESRD within 14 weeks and is currently on chronic peritoneal dialysis. The atypical features of C1q nephropathy observed in our patient, which have not been described in earlier reports, are an early age of onset, severe crescentic glomerulonephritis, and rapid progression to ESRD. C1q nephropathy should be added to the differential diagnosis of glomerulonephritis in young children and in the patient with crescentic glomerulonephritis.
Journal Title
Pediatric nephrology (Berlin, Germany)
Volume
14
Issue
10-11
First Page
976
Last Page
979
MeSH Keywords
Antigen-Antibody Complex; Child, Preschool; Complement C1q; Disease Progression; Female; Glomerulonephritis; Humans; Immunosuppressive Agents; Kidney Diseases; Kidney Failure, Chronic; Time Factors
Recommended Citation
Srivastava, T., Chadha, V., Taboada, E., Alon, U. S. C1q nephropathy presenting as rapidly progressive crescentic glomerulonephritis. Pediatric nephrology (Berlin, Germany) 14, 976-979 (2000).
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