title: De novo C3 glomerulonephritis in a renal allograft.
abstract: C3 glomerulonephritis (C3GN) is a recently described, rare glomerular disease characterized by predominant or sole glomerular C3 deposits. Morphologic features of C3GN are similar to those of dense deposit disease (DDD); however, ribbon-like intramembranous electron-dense deposits are absent in the former. We report a case of de novo C3GN in a renal allograft with morphologic transformation to DDD. A 6-year-old boy presented with congenital left renal agenesis and right ureteropelvic junction obstruction. The patient underwent pyeloplasty but experienced recurrent urinary tract infections. At the age of 22 years, he received a renal allograft from a living related donor. C3GN was diagnosed after 1 year of transplantation; initial histology showed minimal mesangiopathy and this progressed to mesangial proliferation and membranoproliferative features over the next 7 years. Serum creatinine levels were stabilized with anti-rejection treatments for combating repeated episodes of acute rejection; however, glomerular and tubular band-like electron-dense deposits became evident.
authors.affiliation: a Department of Pathology , Yonsei University College of Medicine , Seoul , Korea.
authors.forename: Ji Hae
authors.initials: JH
authors.lastname: Nahm
authors.affiliation: b Department of Surgery , Yonsei University College of Medicine , Seoul , Korea.
authors.forename: Seung Hwan
authors.initials: SH
authors.lastname: Song
authors.affiliation: b Department of Surgery , Yonsei University College of Medicine , Seoul , Korea.|c The Research Institute for Transplantation, Yonsei University , Seoul , Korea.
authors.forename: Yu Seun
authors.initials: YS
authors.lastname: Kim
authors.affiliation: d Department of Pediatrics , Seoul National University Children's Hospital , Seoul , Korea.|e Kidney Research Institute, Medical Research Center , Seoul National University College of Medicine , Seoul , Korea.
authors.forename: Hae-Il
authors.initials: HI
authors.lastname: Cheong
authors.affiliation: a Department of Pathology , Yonsei University College of Medicine , Seoul , Korea.|c The Research Institute for Transplantation, Yonsei University , Seoul , Korea.
authors.forename: Beom Jin
authors.initials: BJ
authors.lastname: Lim
authors.affiliation: c The Research Institute for Transplantation, Yonsei University , Seoul , Korea.|f Department of Internal Medicine , Yonsei University College of Medicine , Seoul , Korea.
authors.forename: Beom Seok
authors.initials: BS
authors.lastname: Kim
authors.affiliation: a Department of Pathology , Yonsei University College of Medicine , Seoul , Korea.|c The Research Institute for Transplantation, Yonsei University , Seoul , Korea.
authors.forename: Hyeon Joo
authors.initials: HJ
authors.lastname: Jeong
mesh_terms: D064591:Allografts; D001706:Biopsy; D003176:Complement C3 / Q000032:analysis*; D018450:Disease Progression; D005455:Fluorescent Antibody Technique; D015432:Glomerulonephritis, Membranoproliferative / Q000276:immunology* / Q000473:pathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007678:Kidney Glomerulus / Q000276:immunology* / Q000648:ultrastructure; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods; D019520:Living Donors; D008297:Male; D008854:Microscopy, Electron; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: C038245:C3 protein, human; D003176:Complement C3; D007166:Immunosuppressive Agents
keywords: C3 glomerulonephritis; dense deposit disease; kidney transplant; rejection