C3 glomerulopathy: experience of a pediatric nephrology center

Yazilitas F., Cakici E. K., Sukur E. D. K., Can G., Gungor T., ORHAN D., ...More

ACTA CLINICA BELGICA, vol.76, no.4, pp.253-257, 2021 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 76 Issue: 4
  • Publication Date: 2021
  • Doi Number: 10.1080/17843286.2020.1713450
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CAB Abstracts, EMBASE, MEDLINE
  • Page Numbers: pp.253-257
  • Keywords: Children, C3 glomerulopathy, alternate complement pathway, eculizumab, immunosuppressive agents, kidney biopsy, CONCLUSIONS
  • Hacettepe University Affiliated: Yes


Background: C3 glomerulopathy (C3G) is an uncommon disease characterized by the deposition of complement factors in the glomeruli due to overactivation and dysregulation of the alternative pathway of complement. Objectives: This study aimed to describe the clinicopathological features, laboratory testing, clinical course, treatment, and outcomes of pediatric patients with C3G. Patients and Methods: We reviewed retrospectively the laboratory testing, kidney biopsy reports, and clinical features of 18 patients at our hospital from 2007 to 2019. Results: There were 18 cases, and the majority of the patients were girls (61.1%). The mean age at diagnosis was 11.3 +/- 3.7 (5-17) years, and nephritic-nephrotic syndrome presentation in patients was more common (11 cases, 61.1%). Hematuria was found in 66.7% of the patients, of which the majority had microscopic hematuria (58.3%). Hypertension was observed in 10 (55.6%) patients. The mean glomerular filtration rate (eGFR) was 95.7 +/- 47.3 mL/min/1.73 m(2), and 24-h urinary protein excretion was 76.2 +/- 48.6 mg/m(2)/h. Sixteen patients (88.9%) received renin-angiotensin-aldosterone system blockers (RASB), and two of them were taking RASB only. The majority of patients (83.3%) were treated with immunosuppressive therapy. Eculizumab was also given to one of them. At the last follow-up, two patients had levels of less than 60 mL/min/1.73 m(2) for eGFR. Seven patients with immunosuppressive treatment achieved complete remission. Conclusion: C3G shows a variable clinical presentation and response to immunosuppressive therapy. In the present study, we observed that the most common presentation was nephritic and/or nephrotic syndrome and partially responded to treatment to RASB and immunosuppressants.