ISSN 1006-298X      CN 32-1425/R

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肾脏病与透析肾移植杂志 ›› 2025, Vol. 34 ›› Issue (5): 491-495.DOI: 10.3969/j.issn.1006⁃298X.2025.05.018

• 病例报告 • 上一篇    下一篇

CFI 复合杂合突变伴 C3 肾炎因子阳性的 C3 肾小球肾炎

  

  • 出版日期:2025-10-28 发布日期:2025-10-30

C3 glomerulonephritis with compound⁃heterozygous mutation of CFI and C3 nephritic factor

  • Online:2025-10-28 Published:2025-10-30

摘要: 青年男性患者,因双下肢水肿就诊,实验室检查示大量蛋白尿,肾小球源性血尿,肾功能正常,补体 C3 降低和 C3 肾炎因子(C3NeF)阳性。肾活检病理表现为肾小球膜增生性病变伴系膜区、基膜内、内皮下和上皮侧电子致密物沉积;免疫荧光 C3+++、IgG+,弥漫颗粒状沉积于系膜区和血管袢。基因测序发现 CFI 复合杂合突变,父母均为杂合子。最终诊断 CFI 复合杂合突变合并 C3NeF 阳性的 C3 肾小球肾炎。醋酸泼尼松、吗替麦考酚酯联合氯沙坦治疗,起初控制良好,后病情进展。


关键词: CFI 基因突变, C3 肾炎因子, C3 肾小球肾炎

Abstract: A young male presented with bilateral lower extremity edema. Laboratory tests indicated mass proteinuria, glomerular originated hematuria, normal renal function, decreased complement 3 (C3) and positive C3NeF. The pathological manifestations were membranoproliferative glomerular lesions accompanied by electron⁃dense deposits in the mesangial area, within the basal membrane, at the subendothelial and epithelial side. Immunofluorescence revealed granular and diffuse deposition of C3+++ and IgG+ in the mesangial area and capillary loops. Gene sequencing identified a compound heterozygous mutation of CFI, and both parents were heterozygous. The final diagnosis was C3 glomerulonephritis with compound⁃heterozygous mutation of CFI and positive C3NeF. The treatment with prednisone acetate, mycophenolate mofetil and losartan was initially well controlled, but the condition progressed later.


Key words: CFI mutation, C3 nephritic factor, C3 glomerulonephritis