Calls Ginesta J, Almirall J, Torras A, Darnell A, Revert L
Nephrology Service, Hospital Clínic i Provincial, Barcelona, Spain.
Clin Nephrol. 1995 Apr;43(4):221-5.
Isolated mesangial C3 proliferative glomerulonephritis is a nephropathy poorly defined among glomerular diseases. Clinical picture is characterized by episodes of gross hematuria and/or persistent or recurrent microhematuria and/or proteinuria. Short-term prognosis (less than 3 years) is considered to be benign, although not much information is available in reference to long-term follow-up. We reviewed all renal biopsies performed in our center between 1978 and 1992 (n = 2,200) in order to study clinical course of these patients. Isolated mesangial C3 deposition was found in 11 cases (0.5%). Isolated proteinuria (> 0.5 g/d) 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 cases. At the time of renal biopsy, renal function was accurately normal in all but one patient. In our series, renal function showed no changes during the first 3 years, accordingly to data referred to in the literature. After 7 years of follow-up, however, renal function was declining in 4 of 5 patients who developed terminal renal failure up to requiring hemodialysis. Therefore, initial benign prognosis ascribed to this glomerulonephritis would not be confirmed in a long-term follow-up.
孤立性系膜C3增殖性肾小球肾炎是一种在肾小球疾病中定义不明确的肾病。临床表现以肉眼血尿发作和/或持续性或复发性镜下血尿和/或蛋白尿为特征。短期预后（小于3年）被认为是良性的，尽管关于长期随访的信息不多。我们回顾了1978年至1992年在我们中心进行的所有肾活检（n = 2200），以研究这些患者的临床病程。11例（0.5%）发现孤立性系膜C3沉积。3例患者存在孤立性蛋白尿（>0.5g/d），2例为肾病综合征。5例患者检测到血尿伴蛋白尿。1例患者血尿是唯一的临床表现。4例观察到动脉高血压。在肾活检时，除1例患者外，所有患者的肾功能均完全正常。在我们的系列研究中，根据文献报道的数据，肾功能在最初3年内没有变化。然而，经过7年的随访，5例发展为终末期肾衰竭直至需要血液透析的患者中有4例肾功能在下降。因此，这种肾小球肾炎最初被认为的良性预后在长期随访中并未得到证实。
