title: Differences in clinical findings, pathology, and outcomes between C3 glomerulonephritis and membranoproliferative glomerulonephritis.
abstract: To clarify the clinical manifestations of pediatric complement component C3 glomerulonephritis (C3GN), we retrospectively evaluated differences in the clinicopathological findings and prognosis between C3GN and immune-complex-mediated membranoproliferative glomerulonephritis (IC-MPGN).
  
  
  
  Thirty-seven patients diagnosed with "idiopathic MPGN" were enrolled in this retrospective study. The patients were divided into two groups, with Group 1 consisting of 19 patients diagnosed with IC-MPGN and Group 2 consisting of 18 patients diagnosed with C3GN. The clinical findings and the prognosis were investigated for both groups.
  
  
  
  Thirteen patients in Group 2 were identified by mandatory annual school screening for urinary abnormalities. The incidence of macro-hematuria and the frequency of low serum C4 values were lower in Group 2 patients than in Group 1 patients. At the time of the second renal biopsy, urinary protein excretion, incidence of hematuria, frequency of low serum C3 values, and scores for mesangial proliferation, glomerular sclerosis, and interstitial fibrosis were higher in Group 2 patients than in Group 1 patients. At the most recent follow-up examination, the number of patients categorized as non-responding or with end-stage renal disease was higher in Group 2 patients than in Group 1 patients.
  
  
  
  Our results suggest that the treatment response and prognosis of patients with C3GN are worse than those of patients with IC-mediated MPGN. Therefore, in the clinical context regarding treatment options and prognosis, it may be useful to classify idiopathic MPGN as C3GN or IC-MPGN. In addition, long-term follow-up of C3GN is necessary.
authors: Department of Pediatrics, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima City, Fukushima, 960-1295, Japan. kyuki@fmu.ac.jp.
authors: Yukihiko
authors: Y
authors: Kawasaki
authors: Department of Pediatrics, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima City, Fukushima, 960-1295, Japan.
authors: Syuto
authors: S
authors: Kanno
authors: Department of Pediatrics, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima City, Fukushima, 960-1295, Japan.
authors: Atsushi
authors: A
authors: Ono
authors: Department of Pediatrics, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima City, Fukushima, 960-1295, Japan.
authors: Yuichi
authors: Y
authors: Suzuki
authors: Department of Pediatrics, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima City, Fukushima, 960-1295, Japan.
authors: Shinichiro
authors: S
authors: Ohara
authors: Department of Pediatrics, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima City, Fukushima, 960-1295, Japan.
authors: Masatoki
authors: M
authors: Sato
authors: Department of Pediatrics, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima City, Fukushima, 960-1295, Japan.
authors: Kazuhide
authors: K
authors: Suyama
authors: Department of Pediatrics, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima City, Fukushima, 960-1295, Japan.
authors: Koichi
authors: K
authors: Hashimoto
authors: Department of Pediatrics, Fukushima Medical University School of Medicine, 1 Hikariga-oka, Fukushima City, Fukushima, 960-1295, Japan.
authors: Mitsuaki
authors: M
authors: Hosoya
mesh_terms: D002648:Child; D003176:Complement C3; D005260:Female; D015432:Glomerulonephritis, Membranoproliferative / Q000453:epidemiology / Q000276:immunology / Q000473:pathology*; D006801:Humans; D007105:Immune Complex Diseases / Q000453:epidemiology / Q000276:immunology / Q000473:pathology*; D007150:Immunohistochemistry; D015994:Incidence; D008297:Male; D012189:Retrospective Studies
chemical_list: D003176:Complement C3
keywords: C3 glomerulonephritis; Children; Clinicopathological findings; Epidemiology; Prognosis