C4 glomerulopathy other diagnostic studies
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Ali Poyan Mehr, M.D. [2]; Associate Editor(s)-in-Chief: Olufunmilola Olubukola M.D.[3]
Overview
Other Diagnostic Studies
A kidney biopsy may be helpful in the diagnosis of C4 glomerulopathy. Findings suggestive of C4 glomerulopathy include[1][2][3][4][5]:
- Membranoproliferative glomerulonephritis, with mesangial and endocapillary hypercellularity.
- The glomerular capillary walls thickening.
- Periodic acid–Schiff stain finding of ribbonlike material on the glomerular basement membrane.
- Immunofluorescence microscopy indicates no glomerular staining for IgA, IgM, IgG, C3, C1q, kappa or lambda light chains.
- Electron microscopy is favorable for large subendothelial osmiophilic dense deposits lining the glomerular basement membrane.
- C4d glomerular staining help as a marker for immune complex-mediated glomerulonephritis.
- Positive C4d can also assist as a marker for glomerulopathy resulting from activation of the Lectin pathway.
References
- ↑ Sethi S, Fervenza FC (2012). "Membranoproliferative glomerulonephritis--a new look at an old entity". N Engl J Med. 366 (12): 1119–31. doi:10.1056/NEJMra1108178. PMID 22435371.
- ↑ Zhang Y, Meyer NC, Wang K, Nishimura C, Frees K, Jones M; et al. (2012). "Causes of alternative pathway dysregulation in dense deposit disease". Clin J Am Soc Nephrol. 7 (2): 265–74. doi:10.2215/CJN.07900811. PMC 3280037. PMID 22223606.
- ↑ Sahin OZ, Gurses S, Taslı F, Yavas H, Ersoy R, Uzum A; et al. (2013). "Glomerular c4d staining can be an indicator of disease activity in lupus nephritis". Ren Fail. 35 (2): 222–5. doi:10.3109/0886022X.2012.743916. PMID 23176021.
- ↑ Espinosa M, Ortega R, Sánchez M, Segarra A, Salcedo MT, González F; et al. (2014). "Association of C4d deposition with clinical outcomes in IgA nephropathy". Clin J Am Soc Nephrol. 9 (5): 897–904. doi:10.2215/CJN.09710913. PMC 4011455. PMID 24578331.
- ↑ Sethi S, Nasr SH, De Vriese AS, Fervenza FC (2015). "C4d as a Diagnostic Tool in Proliferative GN". J Am Soc Nephrol. 26 (11): 2852–9. doi:10.1681/ASN.2014040406. PMC 4625660. PMID 25991041.