C3 glomerulopathy and eculizumab: a report on four paediatric cases.

Background: Eculizumab may be used to treat C3-glomerulopathy (C3G), a rare but severe glomerular disease. Diagnosis and Treatment: Patients 1, 2 and 3 were diagnosed with nephritic syndrome with alternative complement pathway activation (low C3, C3Nef-positive) and C3G at the age of 9, 13 and 12 ye...

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Published in:Pediatric Nephrology Vol. 32; no. 6; pp. 1023 - 1029
Main Authors: Lebreton, Célia, Bacchetta, Justine, Dijoud, Frédérique, Bessenay, Lucie, Fremeaux-Bacchi, Véronique, Sellier-Leclerc, Anne
Format: case study research tables/charts Journal Article
Published: Springer Nature Jun2017
Online Access:View this record in EBSCOhost
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      dt: Jun2017
      vid: 32
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      pub: Springer Nature
      place: New York, New York
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        atl: C3 glomerulopathy and eculizumab: a report on four paediatric cases.
      aug:
        au:
          Lebreton, Célia
          Bacchetta, Justine
          Dijoud, Frédérique
          Bessenay, Lucie
          Fremeaux-Bacchi, Véronique
          Sellier-Leclerc, Anne
        affil: Service de Néphrologie Rhumatologie Dermatologie Pédiatriques, Centre de Référence des Maladies Rénales Rares Hôpital Femme Mère Enfant , Hospices Civils de Lyon , 59 boulevard Pinel 69677 Bron France
      sug:
        subj:
          Kidney Glomerulus Pathology
          Glomerulonephritis Drug Therapy
          Antibodies, Monoclonal Therapeutic Use
          Glomerulonephritis Pathology
          Glomerulonephritis Symptoms
          Proteinuria Urine
          Disease Progression
          Kidney Failure, Chronic Surgery
          Kidney Transplantation
          Recurrence
          Graft Rejection
          Glomerulonephritis Classification
          Antibodies, Monoclonal Pharmacodynamics
          Case Studies
          Male
          Female
          Child
          Adolescence
          Human
          Treatment Outcomes
          Child: 6-12 years
          Adolescent: 13-18 years
          Male
          Female
      ab: Background: Eculizumab may be used to treat C3-glomerulopathy (C3G), a rare but severe glomerular disease. Diagnosis and Treatment: Patients 1, 2 and 3 were diagnosed with nephritic syndrome with alternative complement pathway activation (low C3, C3Nef-positive) and C3G at the age of 9, 13 and 12 years, respectively. Treatment with eculizumab normalized proteinuria within 1, 2 and 7 months, respectively. Proteinuria relapsed when eculizumab was withdrawn, but the re-introduction of eculizumab normalized proteinuria. Patient 4 was diagnosed with C3G at 9 years of age, with progression to end-stage renal disease within 2 years, followed by a first renal transplantation (R-Tx) with early disease recurrence and graft loss within 39 months. After a second R-Tx, she rapidly presented with biological and histological recurrence: therapy with eculizumab was started, with no effect on proteinuria after 5 months, in a complex clinical setting (i.e. association of C3G recurrence, humoral rejection and BK nephritis). Eculizumab was withdrawn due to multiple viral reactivations, but the re-introduction of the drug a few months later enabled a moderate decrease in proteinuria. Conclusion: These cases illustrate the efficacy of eculizumab, at least on native kidneys, in paediatric C3G. However, larger international studies are warranted to confirm the benefit and safety of eculizumab therapy.
      pubtype: Academic Journal
      doctype:
        case study
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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