GL Qian, L Huang, JH Mao, AM Liu

Abstract

Introduction: Acute post-streptococcal glomerulonephritis (APSGN) is a common disease that primarily affects children. At the acute phase of post-streptococcal glomerulonephritis, the level of haemolytic complement plasma C3 always decreases. The hypocomplementaemia is one of the important criteria for diagnosis of APSGN. We identified 3 children with acute post-streptococcal glomerulonephritis diagnosed clinically and pathologically whose plasma C3 levels remained normal range in the acute phase. Case presentation: All of the three patients are Chinese (a 5.8-year-old boy, a 8.8-year-old girl, and a 6.9-year-old girl). Their plasma C3 levels were 0.99 g/L, 0.64 g/L, and 0.66 g/L (normal range: 0.5-1.5 g/L) in the acute phase. Pathological findings showed that subepithelial hump-like dense deposits were present.Conclusion: It is possible for patients with APSGN that serum complement C3 level remains normal range during acute phage. Even if plasma C3 levels are still normal, the possibility of acute post-streptococcal glomerulonephritis cannot be ignored. Renal biopsy and follow-up of C3 level variation will be necessary for definite diagnosis of these patients.