Skip to main content

Advertisement

Log in

C1q nephropathy in two young sisters

  • Original Article
  • Published:
Pediatric Nephrology Aims and scope Submit manuscript

Abstract

C1q nephropathy (C1qNP) is a controversial and uncommon form of glomerulonephritis, characterized by mesangial immunoglobulin and complement deposits, predominantly C1q, with no evidence of systemic lupus erythematosus. Clinically, it may present as nephrotic syndrome and non-nephrotic proteinuria per se or associated with microhematuria, hypertension, or renal insufficiency. We describe two sisters with C1qNP, who presented with steroid-resistant nephrotic syndrome. Both sisters presented before the age of 2 years, and they showed a poor response to other immunosuppressive therapy. Both girls had normal serum complement levels, negative antinuclear antibodies (ANAs) and negative hepatitis B antigen. Renal biopsy in both patients showed histological features of mesangioproliferative glomerulonephritis, with diffuse “full-house” positive immunofluorescence reaction in the mesangial area. The immunofluorescence reaction for C1q was most intense and co-dominant with IgG in both patients. Correspondingly, electron microscopy demonstrated dense deposits mainly in the mesangial areas too. We report on two young sisters with the characteristic features of C1qNP presented in early childhood. To the best of our knowledge, this is the first report of C1qNP in siblings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Jennette JC, Hipp CG (1985) C1q nephropathy: a distinct pathologic entity usually causing nephrotic syndrome. Am J Kidney Dis 6:103–110

    PubMed  CAS  Google Scholar 

  2. Lau KK, Gaber LW, Delos Santos NM, Wyatt RJ (2005) C1q nephropathy: features at presentation and outcome. Pediatr Nephrol 20:744–749

    Article  PubMed  Google Scholar 

  3. Kersnik Levart T, Kenda RB, Avgustin Cavić M, Ferluga D, Hvala A, Vizjak A (2005) C1Q nephropathy in children. Pediatr Nephrol 20:1756–1761

    Article  PubMed  Google Scholar 

  4. Iskandar SS, Browning MC, Lorentz WB (1991) C1q nephropathy: a pediatric clinicopathologic study. Am J Kidney Dis 18:459–465

    PubMed  CAS  Google Scholar 

  5. Sharman A, Furness P, Feehally J (2004) Distinguishing C1q nephropathy from lupus nephritis. Nephrol Dial Transplant 19:1420–1426

    Article  PubMed  CAS  Google Scholar 

  6. Jennette JC, Hipp CG (1985) Immunohistopathologic evaluation of C1q in 800 renal biopsy specimens. Am J Clin Pathol 83:415–420

    PubMed  CAS  Google Scholar 

  7. Jones E, Magil A (1982) Nonsystemic mesangiopathic glomerulonephritis with “full house” immunofluorescence. Pathological and clinical observation in five patients. Am J Clin Pathol 78:29–34

    PubMed  CAS  Google Scholar 

  8. Niaudet P, Gagnadoux MF, Broyer M (1998) Treatment of childhood steroid-resistant idiopathic nephrotic syndrome. Adv Nephrol Necker Hosp 28:43–61

    PubMed  CAS  Google Scholar 

  9. Alshaya HO, Al-Maghrabi JA, Kari JA (2003) Intravenous pulse cyclophosphamide—is it effective in children with steroid-resistant nephrotic syndrome? Pediatr Nephrol 18:1143–1146

    Article  PubMed  Google Scholar 

  10. Srivastava T, Chadha V, Taboada EM, Alon US (2000) C1q nephropathy presenting as rapidly progressive crescentic glomerulonephritis. Pediatr Nephrol 14:976–979

    Article  PubMed  CAS  Google Scholar 

  11. Fukuma Y, Hisano S, Segawa Y, Niimi K, Tsuru N, Kaku Y, Hatae K, Kiyoshi Y, Mitsudome A, Iwasaki H (2006) Clinicopathologic correlation of C1q nephropathy in children. Am J Kidney Dis 47:412–418

    Article  PubMed  Google Scholar 

  12. Markowitz GS, Schwimmer JA, Stokes MB, Nasr S, Seigle RL, Valeri AM, D’Agati VD (2003) C1q nephropathy: a variant of focal segmental glomerulosclerosis. Kidney Int 64:1232–1240

    Article  PubMed  CAS  Google Scholar 

  13. Nishida M, Kawakatsu H, Okumura Y, Hamaoka K (2005) C1q nephropathy with asymptomatic urine abnormalities. Pediatr Nephrol 20:1669–1670

    Article  PubMed  Google Scholar 

  14. Kuwano M, Ito Y, Amamoto Y, Aida K (1993) A case of congenital nephrotic syndrome associated with positive C1q immunofluorescence. Pediatr Nephrol 7:452–454

    Article  PubMed  CAS  Google Scholar 

  15. Sardani Y, Qin K, Haas M, Aronson AJ, Rosenfield RL (2003) Bartter syndrome complicated by immune complex nephropathy. Case report and literature review. Pediatr Nephrol 18:913–918

    Article  PubMed  Google Scholar 

  16. Hanevold C, Mian A, Dalton R (2006) C1q nephropathy in association with Gitelman syndrome: a case report. Pediatr Nephrol 21:1904–1908

    Article  PubMed  Google Scholar 

  17. Roberti I, Sachdev S, Aronsky A, Kim DU (2006) C1q nephropathy in a child with a chromosome 13 deletion. Pediatr Nephrol 21:737–739

    Article  PubMed  Google Scholar 

  18. Ekim M, Ikinciogullari A, Berberoglu M, Tulunay O, Sencer H, Ozkaya N, Reisli I, Tumer N (2002) C1q nephropathy: a case with severe atopic dermatitis. Pediatr Nephrol 17:547–549

    Article  PubMed  Google Scholar 

  19. Skok J, Solomon E, Reid KB, Thompson RA (1981) Distinct genes for fibroblast and serum C1q. Nature 292:549–551

    Article  PubMed  CAS  Google Scholar 

  20. Thompson RA, Haeney M, Reid KB, Davies JG, White RH, Cameron AH (1980) A genetic defect of the C1q subcomponent of complement associated with childhood (immune complex) nephritis. N Engl J Med 303:22–24

    Article  PubMed  CAS  Google Scholar 

  21. Miura-Shimura Y, Nakamura K, Ohtsuji M, Tomita H, Jiang Y, Abe M, Zhang D, Hamano Y, Tsuda H, Hashimoto H, Nishimura H, Taki S, Shirai T, Hirose S (2002) C1q regulatory region polymorphism down-regulating murine c1q protein levels with linkage to lupus nephritis. J Immunol 169:1334–1339

    PubMed  CAS  Google Scholar 

  22. Hannema AJ, Kluin-Nelemans JC, Hack CE, Eerenberg-Belmer AJ, Mallee C, van Helden HP (1984) SLE like syndrome and functional deficiency of C1q in members of a large family. Clin Exp Immunol 55:106–114

    PubMed  CAS  Google Scholar 

  23. Johnson WG (1980) Metabolic interference and the + − heterozygote. a hypothetical form of simple inheritance which is neither dominant nor recessive. Am J Hum Genet 32:374–386

    PubMed  CAS  Google Scholar 

  24. Rollnick B, Day D, Tissot R, Kaye C (1981) A pedigree possible evidence for the metabolic interference hypothesis. Am J Hum Genet 33:823–826

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jameela A. Kari.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kari, J.A., Jalalah, S.M. C1q nephropathy in two young sisters. Pediatr Nephrol 23, 487–490 (2008). https://doi.org/10.1007/s00467-007-0644-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00467-007-0644-6

Keywords

Navigation