LONG-TERM EVOLUTION OF PATIENTS WITH ISOLATED C3 MESANGIAL GLOMERULONEPHRITIS

Isolated mesangial C3 proliferative glomerulonephritis is a nephropath y poorly defined among glomerular diseases. Clinical picture is charac terized by episodes of gross hematuria and/or persistent or recurrent microhematuria and/or proteinuria. Short-term prognosis (less than 3 y ears) is considered to be benign, although not much information is ava ilable in reference to long-term follow-up. We reviewed all renal biop sies performed in our center between 1978 and 1992 (n = 2,200) in orde r to study clinical course of these patients. Isolated mesangial C3 de position was found in 11 cases (0.5%). Isolated proteinuria (>0.5 gld) was present in 3 patients and nephrotic syndrome in 2. Hematuria with proteinuria was detected in 5 patients. In one patient hematuria was the only clinical finding. Arterial hypertension was observed in 4 cas es. At the time of renal biopsy, renal function was accurately normal in all but one patient. In our series, renal function showed no change s during the first 3 years, accordingly to data refered to in the lite rature. After 7 years of follow-up, however, renal function was declin ing in 3 of 5 patients who developed terminal renal failure up to requ iring hemodialysis. Therefore, initial benign prognosis ascribed to th is glomerulonephritis would not be confirmed in a long-term follow-up.