C3 glomerulopathy associated with peripheral retinal drusen: Case report and review of the literature

Abstract

A 46-year-old female was admitted with complaints of fever and generalized bodily swelling and a working phenotypic diagnosis of nephrotic syndrome. Renal function was mildly impaired. A fundus examination revealed multiple whitish-yellow drusen scattered in the inferior mid-periphery of both eyes with an underlying retinal depigmentation/atrophy. A kidney biopsy was repeated, and the cores were examined. Immunofluorescence staining for IgA, IgM, and IgG was negative, but strongly positive C3 staining was seen in the capillary walls and mesangium. These findings were strongly suggestive of C3 glomerulopathy. The detection of drusen led to the use of the appropriate testing and correct diagnosis. The use of fundus examination may provide diagnostic assistance in cases of unexplained glomerulopathy.