skip to main content

C3 glomerulopathy — ESENeph MCQ

Instant feedback + full explanation. One question, done properly.

HardGlomerulonephritisC3 glomerulopathyESENeph

A 22-year-old man has persistent microscopic haematuria and proteinuria after a flu-like illness. Creatinine is 118 micromol/L, C3 is low and C4 is normal. Anti-streptolysin O titre is negative and C3 remains low 12 weeks later. Biopsy shows mesangial and capillary wall C3 deposition with scant immunoglobulin. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — C3 glomerulopathy

Persistent isolated low C3 with dominant C3 staining and scant immunoglobulin supports C3 glomerulopathy. Post-streptococcal glomerulonephritis usually has transient complement consumption that recovers within weeks. IgA nephropathy has mesangial IgA deposition and usually normal complement. The pearl is that C3 glomerulopathy should prompt evaluation of alternative complement pathway dysregulation.

Reference: KDIGO 2021 Glomerular Diseases Guideline