Clinical Presentation and Outcome of c1q Nephropathy - A Single-Centre Prospective Study
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2018, Vol 6, Issue 6
Abstract
Background: C1q nephropathy is a rare glomerular disease with characteristic mesangial c1q deposition noted on immunofluorescence microscopy. It is histologically defined and poorly understood. Light microscopic features are heterogeneous and comprise minimal change disease, focal segmental glomerulosclerosis (FSGS), and proliferative glomerulonephritis (GN). Aim: This study aims to study the clinical presentation, histopathological profile, and outcomes in patients with c1q nephropathy. Methods: A total of 13 patients who satisfied the above criteria were studied. Clinical profile and laboratory parameters including urine analysis, urine spot protein-creatinine ratio, blood biochemistry, serum complement, and histopathological profile were analyzed. Creatinine clearance was estimated using Cockgraut Gault formula. They were followed up for the assessment of response to treatment. Results: Among the 13 patients, 12 were female (92.3%). All (100%) were hypertensive at the time of presentation. Age ranged from 15 to 48 year with the mean of 34 years. Microscopic hematuria was found in all 13 patients (100%). Nephrotic proteinuria was found in 10 patients (77%), and 4 patients (30.7%) had GFR <60 mL/min. The kidney biopsy revealed diffuse proliferative glomerular nephritis (DPGN) in 12 patients (92.3%), one patient had FSGS (7.7%). Cellular crescents were found in 2 patients (15.3%). One patient was lost for follow-up. 3 patients (25%) improved with ACE inhibitors and statins. 9 patients (69.2%) were started on steroids, of which the four patients who had renal failure received cyclophosphamide in addition to steroids. Of the nine patients, complete remission was found in 2 patients (22%), partial remission in 2 patients (22%), and no response to immunosuppressive medication was seen in 5 patients (55.5%) (one patient had FSGS and four patients had DPGN). Conclusion: Of the 13 cases with c1q nephropathy, all patients had hypertension and microscopic hematuria. Nephrotic proteinuria was seen in three-fourths of the patients. The most common histopathological presentation was diffuse proliferative GN. Half of the patients showed poor response to oral steroids.
Authors and Affiliations
V Kannan Bhaba, N Gopalakrishnan, C Ilango, P K Senthil Kumar, R P Senthil, Heber Anandan
Keywords
Related Articles
- EP ID EP481953
- DOI -
- Views 144
- Downloads 0
Comparison of Tear Film Break-up Time with Schirmer’s Test with Anesthesia to Detect Tear Film Abnormality in Patients with Pterygium - A Study from Jammu and Kashmir
Background: Pterygium appears as a triangular fold of vascularized conjuctiva, the apex lies towards the cornea and base merges with the sub-conjunctival tissue. Generally, it is asymptomatic but may cause redness, lacri...
Role of Laparoscopy in Diagnosing and Staging of Abdominal Malignancies: A Prospective Study
Introduction: In the diagnosis of abdominal/extra-abdominal malignancies, a wide range of non-invasive techniques are available to the present day surgeon. The diagnosis and staging of malignancies have been revolutioniz...
Comparison of Dexamethasone and Tramadol as Adjuvant to Levobupivacaine in Supraclavicular Block: A Clinical Study
Background: Application of supraclavicular block mostly includes surgery of elbow, forearm, and hand. The present study was conducted to evaluate and compare dexamethasone and tramadol as an adjuvant to levobupivacaine i...
Outcome of Retrograde Interlocking Intramedullary Nailing for Fracture Shaft of Femur and Extra-articular Distal Femur
Introduction: Retrograde nailing represents an established fixation method for fractures of the distal femur and offers in femoral shaft fractures an alternative to the existing technique of antegrade nailing. The aim of...
A Rare Case of Bilateral Adrenal Hemorrhage
Bilateral adrenal hemorrhage is a rare condition that may lead to acute adrenal crises, shock, and death, if untreated. It is associated with a 15% mortality rate and 55–60% mortality, if secondary to Waterhouse–Frideric...