C3 glomerulopathy is a rare histopathologic pattern of kidney injury with an underlying pathophysiology that refers to a dysregulation of the alternative pathway of complement in the glomeruli microenvironment. We report a case of a 67- year- old male referred to nephrology by his general practitioner due to acute kidney injury associated with a two- month- long flu- like syndrome. Primary nephrologist assessment as to the possible causes revealed primary HIV infection already in the seroconversion phase and an IgG kappa monoclonal peak on serum immunofixation with an IgG plus kappa free light chain (kappa FLC) monoclonal peak on urinary immunofixation. Kidney biopsy revealed C3 glomerulopathy with cast nephropathy. A multidisciplinary team with an individualized approach to manage such a challenging mix of immune disturbances was needed to render a positive outcome. The authors describe this case to emphasize the growing relationship between two diseases that tend to become increasingly prevalent as life expectancy of both conditions increases.
Coutinho et al. (Sun,) studied this question.