Abstract: SA-PO0725
A Rare Case of C3 Glomerulonephritis in a 45-Year-Old Filipino Man with Type 2 Diabetes
Session Information
- Glomerular Diseases: Complement-Mediated Glomerulopathies and Infection-Related GN
October 24, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Glomerular Diseases
- 1402 Glomerular Diseases: Clinical, Outcomes, and Therapeutics
Authors
- Dy, Jefferson C., Perpetual Succour Hospital, Cebu City, Central Visayas, Philippines
- Darunday, Grecia Porol, Perpetual Succour Hospital, Cebu City, Central Visayas, Philippines
- Iway, Cathleen B., Perpetual Succour Hospital, Cebu City, Central Visayas, Philippines
- Valles, Niki Santino Bonje, Perpetual Succour Hospital, Cebu City, Central Visayas, Philippines
Introduction
C3 glomerulonephritis (C3GN) is a rare primary glomerulonephritis defined by dominant C3 staining on immunofluorescence with electron-dense deposits. Diabetes remains the leading global cause of ESRD. Diabetic kidney disease (DKD) is usually diagnosed clinically without biopsy. However, rapidly progressive kidney failure, hematuria, or active urinary sediments should prompt evaluation for concurrent glomerulonephritis. Complement activation in DKD may overlap with C3GN pathophysiology. We present a case of a Filipino diabetic male with concurrent DKD and C3GN.
Case Description
A 45-year-old male with poorly controlled diabetes presented with 1-month history of bipedal edema, exertional dyspnea, and hypertension. Creatinine rose rapidly from 1.16 to 2.4 mg/dL within one month. Labs showed subnephrotic proteinuria (UACR 1515.82), hematuria (RBC 22-24/hpf), pyuria (WBC 8-10/hpf), and granular casts. HIV, HBV, HCV were negative. ANA and Anti-ASO negative. C3 low (21.92 mg/L), C4 normal (24.3 mg/dL). Renal ultrasound showed normal-sized kidneys. Kidney biopsy revealed arteriolar hyalinosis, thickened tubular basement membranes, and nodular mesangial expansion (consistent with DKD), plus dominant C3 staining on IF and subepithelial/mesangial/intramembranous electron-dense deposits on EM – diagnostic of DKD with superimposed C3GN. Patient was treated with Prednisone (1mg/kg/day) and Mycophenolate mofetil (1g/day) with a slight decrease in creatinine from 2.4 mg/dl to 1.9 mg/dl, however urine albumin-to-creatinine ratio increased from 1515.82 mgMAlb/gC to 6974.56 mgMAlb/gC after 1 month.
Discussion
C3GN superimposed on DKD is rare but should be suspected in diabetics with atypical features. KDIGO 2021 provides no specific guidance for this coexistence. Early kidney biopsy with IF and EM is crucial. Early immunosuppression may improve renal survival.
Acknowledgment
The authors used a large language model (DeepSeek) solely for grammar and sentence structure refinement. No AI was used to generate scientific content, clinical conclusions, or interpretative analysis