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18 May 2023 : Case report  Spain

[In Press] A 78-Year-Old Man with Chronic Kidney Disease and Monoclonal Gammopathy Who Developed Post-Transplant C3 Glomerulopathy – Recurrence or De Novo? A Case Report and Literature Review

Challenging differential diagnosis, Rare coexistence of disease or pathology

María Carmen Ruiz-Fuentes ORCID logo1ABEF, Mercedes Caba-Molina ORCID logo2D, Aurora Polo-Moyano1B, Magdalena Palomares-Bayo1B, Pilar Galindo-Sacristan1B, Carmen De Gracia-Guindo ORCID logo1E

DOI: 10.12659/AJCR.939726

Am J Case Rep In Press; DOI: 10.12659/AJCR.939726  

Available online: 2023-05-18, In Press, Corrected Proof

Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule


The incidence of glomerular disease recurrence in kidney transplant patients varies according to type of glomerulopathy; therefore, it is important to know the primary chronic kidney disease etiology. C3 glomerulopathy (C3G) is characterized by deposits of C3 in immunofluorescence and its pathogeny is based on the dysregulation of the alternative complement pathway. C3G has a high recurrence rate and, given its low prevalence, only case series have been published. A higher rate of recurrence and a more aggressive course have been described in association with monoclonal gammopathy (MG).
We describe the case of a 78-year-old man with chronic kidney disease of unknown etiology (no significant proteinuria) and monoclonal IgGl gammopathy with low risk of progression, who received a kidney transplant, presenting accelerated deterioration of kidney function. Histopathology showed predominant C3 deposits in immunofluorescence, compatible with C3 glomerulonephritis (C3GN). He was treated with eculizumab during 4 weeks while the study was completed. The response to treatment was not favorable and the patient remained in the dialysis program.
Further studies are needed to explain the pathogenic mechanisms of complement alternative pathway dysregulation mediated by monoclonal component in patients with C3GN and MG. Patients older than 50 years who are on a waiting list for kidney transplantation should have an MG detection study. The information provided to patients with MG on a waiting list for kidney transplantation should include not only the possibility of hematologic progression but also the recurrence/de novo appearance of associated kidney pathology.

Keywords: Kidney Transplantation; Paraproteinemias; Recurrence

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06 Jun 2023 : Case report  Saudi Arabia

A Classical Case of Cesarean Scar Endometriosis in a 35-Year-Old Woman Presenting with Cyclical Abdominal P...

Am J Case Rep In Press; DOI: 10.12659/AJCR.940200  

05 Jun 2023 : Case report  USA

Peri-Hilar Cystic Lymphangioma Mimicking a Biliary Cystic Lesion Causing Biliary Obstruction: A Case Report...

Am J Case Rep In Press; DOI: 10.12659/AJCR.939421  

05 Jun 2023 : Case report  Palestinian Territory, Occupied

Recurrent Bioprosthetic Valve Serratia marcescens Endocarditis in Intravenous Drug Users

Am J Case Rep In Press; DOI: 10.12659/AJCR.939292  

05 Jun 2023 : Case report  USA

Successful Treatment of Recurrent Colonic Adenocarcinoma with Metastatic Tumor Thrombus in the Superior Mes...

Am J Case Rep In Press; DOI: 10.12659/AJCR.939156  

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American Journal of Case Reports eISSN: 1941-5923
American Journal of Case Reports eISSN: 1941-5923