Table of Contents

HK J Paediatr (New Series)
Vol 19. No. 3, 2014

HK J Paediatr (New Series) 2014;19:188-191

Case Report

Acute Post-streptococcal Glomerulonephritis with Normal Range Complement C3 Level: Three Case Reports

GL Qian, L Huang, JH Mao, AM Liu


Introduction: Acute post-streptococcal glomerulonephritis (APSGN) is a common disease that primarily affects children. At the acute phase of post-streptococcal glomerulonephritis, the level of haemolytic complement plasma C3 always decreases. The hypocomplementaemia is one of the important criteria for diagnosis of APSGN. We identified 3 children with acute post-streptococcal glomerulonephritis diagnosed clinically and pathologically whose plasma C3 levels remained normal range in the acute phase. Case presentation: All of the three patients are Chinese (a 5.8-year-old boy, a 8.8-year-old girl, and a 6.9-year-old girl). Their plasma C3 levels were 0.99 g/L, 0.64 g/L, and 0.66 g/L (normal range: 0.5-1.5 g/L) in the acute phase. Pathological findings showed that subepithelial hump-like dense deposits were present.Conclusion: It is possible for patients with APSGN that serum complement C3 level remains normal range during acute phage. Even if plasma C3 levels are still normal, the possibility of acute post-streptococcal glomerulonephritis cannot be ignored. Renal biopsy and follow-up of C3 level variation will be necessary for definite diagnosis of these patients.

引言:急性鏈球菌感染後腎小球腎炎是兒童常見疾病。在急性期,溶血性血漿補體C3的水平往往下降,因此,低補體血症是急性鏈球菌感染後腎小球腎炎的重要診斷標準。我們鑒定了3例臨床和病理確診急性鏈球菌感染後腎小球腎炎,而其急性期補體C3水平正常。病例表現:所有3例患者均為中國籍(5.8歲男孩,8.8歲女孩,6.9歲女孩)。其急性期C3水平為0.99 g/L、0.64 g/L和0.66 g/L(正常值:0.5-1.5 g/L)。結論:病童在急性鏈球菌感染後,其腎小球腎炎急性期血補體C3水平有可能保持在正常的水平。因此,即使C3水平正常,醫顧人員仍然不能忽略鏈球菌感染後腎小球腎炎出現的可能性。腎穿刺活檢和C3水平的動態隨訪對確診此類患者是必要的。

Keyword : Acute post-streptococcal glomerulonephritis; Haemolytic complement plasma C3; Kidney biopsy



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