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cytoplasmic antineutrophil cytoplasmic antibodies and perinuclear anti-neutrophil cytoplasmic antibodies were negative&#44; serum C3 and C4 levels were normal&#46; Kidney biopsy was performed&#46; The biopsy contained 7 glomeruli which showed mesangial hypercellularity&#44; segmental endocapillary proliferation&#44; basement membrane thickening and duplication &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>A&#44; B&#41;&#46; Fibrocellular crescents were detected in 2 glomeruli &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>B&#41;&#46; Focal segmental sclerosis was present in 40&#37; of glomeruli&#46; Immunofluorescence staining showed marked granular capillary wall and mesangial C3 deposition &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>C&#41;&#46; Glomerular C1q and immunoglobulins were absent&#46; The biopsy findings were consistent with C3G with a membranoproliferative pattern&#46; Further classification of C3G could not be done&#44; since electron microscopic examination was not available due to insufficient biopsy material&#46; The patient was treated with 1<span class="elsevierStyleHsp" style=""></span>mg&#47;kg&#47;day methylprednisolone and 1<span class="elsevierStyleHsp" style=""></span>g&#47;day mycophenolate mofetil &#40;MMF&#41;&#44; and previous treatment with ramipril was maintained&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Two months later&#44; she was admitted to our clinic with shortness of breath with widely distributed crackles and ronchi on auscultation of both lungs&#46; She had 3<span class="elsevierStyleHsp" style=""></span>&#43;<span class="elsevierStyleHsp" style=""></span>pretibial pitting edema in both legs&#46; Laboratory results showed renal failure &#40;serum creatinine&#58; 3&#46;2<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#44; uric acid&#58; 8&#46;2<span class="elsevierStyleHsp" style=""></span>mg&#47;dL&#44; Na&#58; 126<span class="elsevierStyleHsp" style=""></span>mmol&#47;L&#41; with non-immune hemolytic anemia and thrombocytopenia&#46; ADAMTS13 level was 30&#37;&#46; Atypical HUS was diagnosed and eculizumab treatment started after 5 sessions of plasmapheresis with hemodialysis because of persistent hypervolemia&#46; Mycophenolate mofetil treatment was stopped because of thrombocytopenia&#46; Genotyping of patient was performed with Sanger sequencing of <span class="elsevierStyleItalic">CFH</span> and <span class="elsevierStyleItalic">CFI</span> genes&#46; Homozygosity for single-nucleotide polymorphism &#40;SNPs&#41; rs2298749 on 6 exon of <span class="elsevierStyleItalic">CFI</span> &#91;S268S &#40;TCG<span class="elsevierStyleHsp" style=""></span>&#62;<span class="elsevierStyleHsp" style=""></span>TCA&#41;&#93; was detected&#46; Hemodialysis was continued three times a week&#46; After eight months of eculizumab therapy her serum creatinine levels were decreased to 3&#8211;4<span class="elsevierStyleHsp" style=""></span>mg&#47;dL and her hemodialysis was further reduced to once a week&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">C3 glomerulopathy is defined as the presence of C3 deposits without immunoglobulins on immunofluorescence microscopy along with subendothelial and mesangial electron-dense deposits by electron microscopy&#46; Electron microscopy is required to differentiate C3 glomerulonephritis from dense deposit disease&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> Although similarity between C3G and postinfectious glomerulonephritis is well known&#44; we excluded postinfectious glomerulonephritis by clinical and follow-up data along with the presence of basement membrane changes by light microscopy&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Mutations in <span class="elsevierStyleItalic">CFH</span>&#44; <span class="elsevierStyleItalic">CFI</span> and C3&#44; and&#44; the presence of anti-CFH antibodies have been previously demonstrated in patients with C3G and aHUS<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> and based on these findings authors recommended that special diagnostic tests &#91;C3NeF&#44; serum factor H&#44; complement factor H-related &#40;CFHR&#41; protein gene mutations&#44; serum factor B&#44; serum factor I&#44; and membrane cofactor protein &#40;MCP or CD46&#41;&#44; soluble C5b-9&#44; complement factor H-related &#40;CFHR&#41; protein gene mutations&#93; should be obtained in patients with DDD or C3G&#46;<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">1&#8211;3</span></a> In our patient&#44; we found a single nucleotide polymorphism in <span class="elsevierStyleItalic">CFI</span> gene&#59; this SNP is not a disease-associated mutation but may cause susceptibility to these diseases&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">To our knowledge&#44; there is no prospective randomized trial on the treatment of C3G yet&#46; Treatment suggestions are based on recent KDIGO meeting report&#46;<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">1</span></a> In the present case&#44; we also started MMF plus steroid regimen however we stopped MMF earlier because of persistent thrombocytopenia&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Eculizumab is a humanized monoclonal antibody that binds with high affinity to C5 and has been approved by FDA and EMA for the treatment of aHUS&#46; Eculizumab prevents cleavage of C5&#44; thereby precluding formation of C5a and the terminal complement complex &#40;C5b-9&#41;&#44; which has been implicated in the pathogenesis of both DDD and C3G&#46;<a class="elsevierStyleCrossRefs" href="#bib0050"><span class="elsevierStyleSup">4&#8211;6</span></a> In our case&#44; eculizumab treatment resulted improvement of her residual renal function&#46; Eculizumab is a potent drug that can act even though in stage 5 kidney failure&#46; Although re-biopsy could not be performed because of thrombocytopenia&#44; treatment with eculizumab improved her renal function&#44; including with long standing fibrotic changes&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">In conclusion&#44; we present a patient who was initially admitted with nephritic syndrome and C3G was diagnosed and immunosuppressive treatment was initiated&#44; two months later after diagnosis she was re-admitted with thrombotic microangiopathy and aHUS was diagnosed&#46; After administration of eight month of eculizumab therapy her residual renal clearance improved and her dialysis treatment was further reduced to once a week&#46; The present case report demonstrated a <span class="elsevierStyleItalic">CFI</span> genetic variation associated alternative pathway dysregulation causing C3G and aHUS in the same patient and highlighted the shared pathogenesis in these alternative complement pathway associated diseases&#46;</p></span>"
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Glomerular mesangial and endocapillary hypercellularity &#40;A&#41;&#44; basement membrane duplication and crescent formation &#40;B&#41;&#44; and&#44; mesangial and capillary C3 deposits by immunfluoresence &#40;C&#41; in renal biopsy &#40;A&#44; hematoxylin&#8211;eosin&#59; B&#44; periodic acid methenamin silver&#59; C&#44; anti-C3 FITC&#41;&#46;</p>"
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                    0 => array:2 [
                      "titulo" => "Atypical hemolytic uremic syndrome and C3 glomerulopathy&#58; conclusions from a &#8220;Kidney Disease&#58; Improving Global Outcomes&#8221; &#40;KDIGO&#41; Controversies Conference"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "T&#46;H&#46; Goodship"
                            1 => "H&#46;T&#46; Cook"
                            2 => "F&#46; Fakhouri"
                            3 => "F&#46;C&#46; Fervenza"
                            4 => "V&#46; Fr&#233;meaux-Bacchi"
                            5 => "D&#46; Kavanagh"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.kint.2016.10.005"
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                        "tituloSerie" => "Kidney Int"
                        "fecha" => "2017"
                        "volumen" => "91"
                        "paginaInicial" => "539"
                        "paginaFinal" => "551"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27989322"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0040"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Dimerization of complement factor H-related proteins modulates complement activation in vivo"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "E&#46; Goicoechea de Jorge"
                            1 => "J&#46;J&#46; Caesar"
                            2 => "T&#46;H&#46; Malik"
                            3 => "M&#46; Patel"
                            4 => "M&#46; Colledge"
                            5 => "S&#46; Johnson"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1073/pnas.1219260110"
                      "Revista" => array:5 [
                        "tituloSerie" => "Proc Natl Acad Sci U S A"
                        "fecha" => "2013"
                        "volumen" => "110"
                        "paginaInicial" => "4685"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23487775"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0045"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Identification of a mutation in complement factor H-related protein 5 in patients of Cypriot origin with glomerulonephritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46;P&#46; Gale"
                            1 => "E&#46;G&#46; de Jorge"
                            2 => "H&#46;T&#46; Cook"
                            3 => "R&#46; Martinez-Barricarte"
                            4 => "A&#46; Hadjisavvas"
                            5 => "A&#46;G&#46; McLean"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/S0140-6736(10)60670-8"
                      "Revista" => array:5 [
                        "tituloSerie" => "Lancet"
                        "fecha" => "2010"
                        "volumen" => "376"
                        "paginaInicial" => "794"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20800271"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0050"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recurrent dense deposit disease after renal transplantation&#58; an emerging role for complementary therapies"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "J&#46;A&#46; McCaughan"
                            1 => "D&#46;M&#46; O&#8217;Rourke"
                            2 => "A&#46;E&#46; Courtney"
                          ]
                        ]
                      ]
                    ]
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                    0 => array:2 [
                      "doi" => "10.1111/j.1600-6143.2011.03923.x"
                      "Revista" => array:5 [
                        "tituloSerie" => "Am J Transplant"
                        "fecha" => "2012"
                        "volumen" => "12"
                        "paginaInicial" => "1046"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22233157"
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                      "titulo" => "Eculizumab in a patient with dense-deposit disease"
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                          "autores" => array:3 [
                            0 => "E&#46; Daina"
                            1 => "M&#46; Noris"
                            2 => "G&#46; Remuzzi"
                          ]
                        ]
                      ]
                    ]
                  ]
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                    0 => array:2 [
                      "doi" => "10.1056/NEJMc1112273"
                      "Revista" => array:5 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2012"
                        "volumen" => "366"
                        "paginaInicial" => "1161"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22435382"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
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              "identificador" => "bib0060"
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              "referencia" => array:1 [
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                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Eculizumab for the treatment of dense-deposit disease"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "M&#46; Vivarelli"
                            1 => "A&#46; Pasini"
                            2 => "F&#46; Emma"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1056/NEJMc1111953"
                      "Revista" => array:5 [
                        "tituloSerie" => "N Engl J Med"
                        "fecha" => "2012"
                        "volumen" => "366"
                        "paginaInicial" => "1163"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22435383"
                            "web" => "Medline"
                          ]
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                ]
              ]
            ]
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        "texto" => "<p id="par0050" class="elsevierStylePara elsevierViewall">The authors declare that they have no sources of funding for this study&#44; and they have no conflicts of interest to declare&#46;</p>"
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