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Open Access Research

The continual presence of C3d but not IgG glomerular capillary deposition in stage I idiopathic membranous nephropathy in patients receiving corticosteroid treatment

Rui Zhang12, Zhi-yong Zheng1*, Jian-song Lin1, Li-juan Qu1 and Feng Zheng3

Author affiliations

1 Department of Pathology, Dongfang Hospital, Fujian Medical University, Fuzhou 350025, China

2 Department of Pathology, The second Hospital of Xiamen, Xiamen, 361021, China

3 Department of Nephrology, Dongfang Hospital, Fujian Medical University, Fuzhou, 350025, China

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Citation and License

Diagnostic Pathology 2012, 7:109  doi:10.1186/1746-1596-7-109

Published: 21 August 2012

Abstract

Background

Pathologic diagnosis of stage I idiopathic membranous nephropathy (MN-I) requires electron microscopy or immunohistochemistry that shows a glomerular capillary staining pattern of IgG and C3. However, it is not uncommon that renal biopsy did not obtain sufficient material for electron microscopy and that IgG and C3 staining in glomeruli largely lost at biopsy due to corticosteroid treatment. Since C3d is one of the final degradation products of C3 that is more stable in vivo, we determine if C3d staining could be used as a novel immunohistochemical marker for MN-I.

Methods and results

74 MN-I patients with electron microscopy proven MN-I were examined by immunoperoxidase staining of C3d. Intensive C3d staining was present in glomerular capillary like the staining pattern of IgG and C3 in MN-I. Importantly, in 40 MN-I patients who underwent corticosteroid treatment at biopsy the intensity and glomerular capillary pattern of C3d staining remained largely intact while the staining for IgG had substantially reduced and the pattern of glomerular capillary staining became unrecognizable.

Conclusions

C3d glomerular capillary staining may be a novel marker for pathologic diagnosis of MN-I that is continuously present at biopsy in patient who has received corticosteroid treatment.

Virtual slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2120780075734479 webcite

Keywords:
C3d; Membranous Nephropathy; Immune deposit