Durable remission of C3 glomerulonephritis with mycophenolate mofetil

• Published in: Nephrology (Carlton, Vic.) Vol. 22; no. S1; pp. 36 - 39
• Main Authors: Lioufas, Nicole, Finlay, Moira, Barbour, Thomas
• Format: Journal Article
• Language: English
• Published: Australia Wiley Subscription Services, Inc 01.02.2017
• Subjects: Alternative pathway; Complement activation; Complement C3; Complement component C3; Corticosteroids; Enzyme Inhibitors - therapeutic use; Glomerulonephritis; Glomerulonephritis - diagnosis; Glomerulonephritis - drug therapy; Glomerulonephritis - etiology; Humans; Light chains; Male; Middle Aged; Monoclonal gammopathy; Mycophenolate mofetil; Mycophenolic acid; Mycophenolic Acid - therapeutic use; Paraproteinemias - diagnosis; Paraproteinemias - drug therapy; Paraproteinemias - etiology; Remission; Remission Induction; Renal failure; Steroid hormones
• ISSN: 1320-5358; 1440-1797
• DOI: 10.1111/nep.12939

In C3 glomerulopathy, uncontrolled complement C3 activation via the alternative pathway results in glomerular C3 deposition and, in many cases, progressive renal failure. Despite advances in understanding of C3G pathogenesis over the last few years, there are no proven treatments. We describe a patient in whom C3 glomerulopathy was associated with renal impairment and elevated serum free kappa light chains. An initial response to corticosteroids was followed by relapse once steroids were weaned, prompting use of mycophenolate mofetil to maintain remission. We discuss some of the diagnostic and therapeutic issues surrounding C3G, including in the setting of monoclonal gammopathy. Summary at a Glance A patient with C3 glomerulonephritis in whom initial response to steroids later necessitated use of mycophenolate mofetil to maintain remission.