ArticleKidney international reports2019
Glomerular C4d Staining Does Not Exclude a C3 Glomerulopathy.
Article in Kidney international reports, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 24 citations in OpenAlex.
- Expert Discussion on Immune Complex-Mediated Membranoproliferative Glomerulonephritis: Challenges and Considerations.Advances in therapy · 2025Article
- C3 glomerulopathy associated with mycoplasma pneumoniae infection and positive IgA staining.BMC nephrology · 2025Article
- Challenges in the Diagnosis and Management of Immune Complex-Mediated Membranoproliferative Glomerulonephritis and Complement 3 Glomerulopathy.Kidney international reports · 2025Review
- C3 Glomerulopathy: Novel Treatment Paradigms.Kidney international reports · 2024Review
- Immunoelectron microscopy findings in a patient with C3 glomerulonephritis.Clinical nephrology. Case studies · 2023Article
- Alternative pathway diagnostics.Immunological reviews · 2023Review
- A clinical approach to children with C3 glomerulopathy.Pediatric nephrology (Berlin, Germany) · 2022Review
- Therapy and outcomes of C3 glomerulopathy and immune-complex membranoproliferative glomerulonephritis.Pediatric nephrology (Berlin, Germany) · 2021Article
- Antibody-mediated complement activation in pathology and protection.Immunology and cell biology · 2020Review
- Utility of immunohistochemistry with C3d in C3 glomerulopathy.Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc · 2020Article
- A Narrative Review on C3 Glomerulopathy: A Rare Renal Disease.International journal of molecular sciences · 2020Review
- Immunofluorescence Use and Techniques in Glomerular Diseases: A Review.Glomerular diseasesReview
- A Novel Glomerular C4d Scoring System: A Tool to Prognosticate Proliferative Exudative Pattern of Glomerular Injury.Indian journal of nephrologyArticle
- C4d in Proliferative Glomerulonephritis.Indian journal of nephrologyArticle
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Authors and funding
12 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionC4d, an early product in the classical/lectin complement pathway has shown potential in the evaluation of C3 glomerulopathy where its absence would support an alternative pathway abnormality. As autoimmune/genetic complement testing is not readily available to most parts of the world, glomerular C4d staining may serve as a useful additional step toward the diagnosis.
methodsTo test this hypothesis, C4d staining was performed on a large cohort of C3 glomerulopathy. Archival cases from 2011 to 2017 were reviewed and immunohistochemistry for C4d was performed, scored (scale of 0 to 3+), and correlated with the immunofluorescence and ultrastructural findings. Paraffin immunofluorescence was performed in cases of "discordant C4d" to unmask Igs.
resultsTwenty-seven cases of dense deposit disease (DDD) and 14 cases of C3 glomerulonephritis (C3GN) were retrieved. C4d demonstrated a range of staining intensities with negative/traces in only 22% of DDD and 64% of C3GN. Lower-intensity C4d staining (1 to 2+) was mostly concordant with similar amounts of Igs/C1q. Discordant 3+ staining was noted in approximately 50% of cases of DDD and 20% of cases of C3GN. Among them, paraffin immunofluorescence unmasked polyclonal Igs in 2 of 5 cases of DDD and 1 of 3 cases of C3GN.
conclusionThis observational study suggests that the presence of glomerular C4d should not exclude a C3 glomerulopathy. In lower intensities, it appears to represent overlying classical/lectin pathway activation with concordant Ig/C1q deposits. A subset of cases, however, displays intense and discordant C4d staining, which raises the possibility of an associated lectin pathway abnormality, a potential future area of study.
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