Table Info

Table 3.

Comparison between this case report and previously reported cases

Diagnostic tools and treatment	Case 1 (our patient)	Case 2 [4]	Case 3 [10]	Case 4 [11]
Age/Gender	19-year-old man	42-year-old man	17-year-old man	77-year-old woman
Clinical presentation	Recurrent nausea, decreased appetite, weight loss	High grade fever, chills, nausea, vomiting, decreased urine output, lower limbs edema, high blood pressure	Isolated selective proteinuria, in routine study, normal renal function	Facial and lower limbs edema, high blood pressure, oliguria
Lab tests	Elevated creatinine Autoimmune workup: negative Serologies (HBV, HCV, etc.): negative Normal C3 C4	Elevated creatinine Autoimmune workup: negative Serologies: negative Normal C3 C4	Normal creatinine Autoimmune workup: negative Serologies: negative Normal C3 C4	Elevated creatinine Autoimmune workup: negative Serologies: negative Normal C3
Urine test	Proteinuria No hematuria	Proteinuria Hematuria	Proteinuria No hematuria	Proteinuria Hematuria
Imaging (abdominal and kidney ultrasound)	Chronic nephropathy	Bilateral bulky kidneys with normal echotexture	Normal	Normal
Biopsy	Major reduction in renal mass, one crescent, acute interstitial nephritis with tubular necrosis, marked thickening of the vascular walls IF: mesangial deposits of IgM, C1q and C3. IgA and IgG negative	Suggestive of focal proliferative GN IF: dominant mesangial deposition of C1q with C3	Segmental glomerular sclerosis, moderate increase of mesangial matrix IF: + C1q (dominant), IgA, IgG, IgM, C3, with a granular mesangial distribution	2% tubular atrophy with interstitial fibrosis and mononuclear interstitial infiltrate IF: + IgG, IgA, IgM, C3, C4, C1q (dominant) With strong mesangial and some peripheral capillary staining
Treatment	No response to pulse steroids Immunosuppressive treatment not added ACE inhibitors were prescribed Hemodialysis done Remission after kidney transplant	Some sessions of hemodialysis for the acute renal failure Complete remission after pulse steroids and prednisolone per os	Complete remission after 18 months of treatment with enalapril and losartan	Complete remission after 3 months of treatment with steroids, 2 sessions of cyclophosphamide and some sessions of hemodialysis

HBV: hepatitis B virus; HCV: hepatitis C virus; IF: immunofluorescence

Declarations

Author contributions

VN, RC and JF wrote the first draft of the manuscript. JAN, SB and BBA helped with collection of data. CG was the pathologist who interpreted biopsy results. All authors contributed to revision of manuscript, read and approved the submitted version.

Conflicts of interest

The authors declare that they have no conflicts of interest.

Ethical approval

Not applicable.

Consent to participate

Written informed consent was obtained from the patient.

Consent to publication

Not applicable.

Availability of data and materials

All relevant data are contained within the manuscript.

Funding

Not applicable.

Copyright

References

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10.

Panuncio A, Alba A, Bacigalupe C, Caorsi H, Schwedt E, Otatti G, et al. Nefropatía C1q en un paciente de 17 años. Caso clínico. Rev Med Chil. 2008;136:1307–10. Spanish. [DOI] [PubMed]

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Zhao Y, Fan H, Bao BY, Liu T, You XQ, Li GF. C1q nephropathy in an old woman with acute renal failure: a case report and literature review. Ren Fail. 2014;36:1136–8. [DOI] [PubMed]

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