Pediatric Nephrology

, Volume 20, Issue 9, pp 1273–1278

Clinicopathologic features, outcome, and therapeutic interventions in four children with isolated C3 mesangial proliferative glomerulonephritis

  • Kazuro Yagi
  • Hidehiko Yanagida
  • Keisuke Sugimoto
  • Hiroaki Kuwajima
  • Nobutada Tabata
  • Kosuke Morita
  • Mitsuru Okada
  • Tsukasa Takemura
Original Article

Abstract

Since isolated C3 mesangial proliferative glomerulonephritis in the absence of systemic disease (i-C3-GN) is an uncommon chronic glomerular disease, long-term prognosis and optimal therapeutic intervention for it are not yet fully defined, especially in children. We report clinical features, outcome, and interventions in 4 patients, ranging from 6 to 18 years old, with i-C3-GN. Microscopic or macroscopic hematuria with or without proteinuria was first noted between 3 and 8 years. When present, proteinuria ranged from 0.2 to 1.0 g/24 h. Persistent hypocomplementemia and circulating immune complexes were found in 1 patient. None of the patients had nephrotic syndrome or hypertension. Percutaneous renal biopsy specimens showed varying degrees of mesangial proliferative glomerulonephritis; 2 patients showed mild mesangial proliferation, while others exhibited moderate histologic severity. In 1 patient with a mild mesangial increase, tubulointerstitial changes were associated. Both patients exhibiting mild mesangial changes followed a benign clinical course with normal renal function over 10 years of follow-up. Patients with moderately severe mesangial alteration manifested slight renal function loss and moderate proteinuria at the time of biopsy, but these largely resolved after a six-month course of prednisolone combined with cyclophosphamide, warfarin, and an angiotensin-converting enzyme inhibitor. Thus, clinical manifestations and the need for aggressive treatment appear to vary among pediatric patients with i-C3-GN. Therapy combining prednisolone with immunosuppression seemed to reduce proteinuria and improve glomerular function in patients with moderately severe mesangial proliferation.

Keywords

C3 deposition Glomerulonephritis Pediatric patient Treatment Clinicopathologic features Prognosis 

Copyright information

© IPNA 2005

Authors and Affiliations

  • Kazuro Yagi
    • 1
  • Hidehiko Yanagida
    • 1
  • Keisuke Sugimoto
    • 1
  • Hiroaki Kuwajima
    • 1
  • Nobutada Tabata
    • 1
  • Kosuke Morita
    • 1
  • Mitsuru Okada
    • 1
  • Tsukasa Takemura
    • 1
  1. 1.Department of PediatricsKinki University School of MedicineOsaka-SayamaJapan

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