Clinical Remission and Reduction of Circulating Nephritic Factors by Combining Rituximab With Belimumab in a Case of Complement Factor 3 Glomerulopathy

C3 glomerulopathy (C3G) is caused by dysregulation of the alternative complement pathway (AP), resulting in either dense deposit disease (DDD) or C3-glomerulonephritis (C3GN). Both are characterized by a distinct pattern of glomerular C3 deposition in the absence of immunoglobulins, frequently producing a membranoproliferative glomerulonephritis (MPGN) pattern of injury [1-3]. Patients commonly present with a nephrotic or nephritic syndrome and often with low serum C3 levels, and the diagnosis is confirmed with a kidney biopsy.