Journal Article

Thrombotic microangiopathy mimicking membranoproliferative glomerulonephritis

Damien Brackman, Lisa Sartz, Sabine Leh, Ann-Charlotte Kristoffersson, Anna Bjerre, Ramesh Tati, Veronique Frémeaux-Bacchi and Diana Karpman

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 26, issue 10, pages 3399-3403
Published in print October 2011 | ISSN: 0931-0509
Published online August 2011 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfr422
Thrombotic microangiopathy mimicking membranoproliferative glomerulonephritis

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A 4-year-old boy presented with proteinuria and developed progressive renal failure over 6 years. In the patient’s family, five individuals were affected with atypical haemolytic uraemic syndrome (aHUS) but not the patient. Renal biopsies (n = 3) showed glomerular basement membrane thickening with double contours, endothelial swelling and deposits of C3 and C1q. Electron microscopy revealed mesangial and subendothelial electron-dense deposits. Complement mutations in membrane cofactor protein (Y155D) and C3 (R713W and G1094R) were detected in all affected family members. The patient also had transient autoantibodies to factor H. The findings suggest that aHUS and glomerulopathy resembling membranoproliferative glomerulonephritis may have a common molecular background.

Keywords: complement; C3; haemolytic uraemic syndrome; membranoproliferative glomerulonephritis; eculizumab

Journal Article.  2255 words.  Illustrated.

Subjects: Nephrology

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