ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: PO1900

Case of C3 Glomerulopathy in a Patient with Mesothelioma

Session Information

Category: Onco-Nephrology

  • 1500 Onco-Nephrology

Authors

  • Al-Hasan, Mohammad, Albany Medical Center, Albany, New York, United States
  • Salman, Loay H., Albany Medical Center, Albany, New York, United States
  • Faddoul, Geovani, Albany Medical Center, Albany, New York, United States
Introduction

C3 glomerulopathy has been described in autoimmune diseases and in monoclonal gammopathy caused by plasma cells and B-cell lineage cells malignancies. There have been no reports of C3 glomerulopathy that is associated with mesothelioma. We report here a case of C3 glomerulonephritis was diagnosed in patient with pulmonary mesothelioma.

Case Description

84-year-old male patient presented with shortness of breath with fluid overload and vasculitic rash in the lower extremities, elevated BUN and creatinine and potassium of 5.7. Patient has been diagnosed with resectable pulmonary mesothelioma two months prior to his presentation and had received only one treatment of immune check inhibitor ( Nivolumab plus Ipilimumab) one day prior to admission. Work up was done and showed AKI, proteinuria and hematuria, but negative work up for autoimmune disease or paraproteinemia or an infectious etiology. Decision was made to proceed with kidney biopsy which showed C3-dominant immune-complex mediated glomerulonephritis affecting about 35% of glomeruli with segmental crescent formation in about 5% of the glomeruli, diffuse acute tubular injury and minimal interstitial fibrosis and tubular atrophy.

Discussion

C3 glomerulopathy has been associated with autoimmune diseases and hematological malignancies and is related to uncontrolled activation of the alternative complement pathway, however solid tumors like mesothelioma may also trigger an immune mechanism that would lead to C3 glomerulopathy.
We will discuss the possibility that the C3 glomerulopathy was due to or in association with the recent diagnosis of mesothelioma, also I will discuss the possible mechanisms of this association.