{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T15:19:23Z","timestamp":1783437563262,"version":"3.54.6"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T00:00:00Z","timestamp":1780963200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>C3 glomerulonephritis (C3GN) is a rare kidney disease driven by dysregulation of the alternative complement pathway. We report two challenging cases of patients with C3GN in whom various immunosuppressant therapies have failed to achieve complete remission, prompting treatment with eculizumab, an anti-C5 humanized monoclonal antibody that inhibits the terminal complement pathway. Although transient improvement in kidney function was observed, both patients eventually experienced worsening renal parameters, with increasing proteinuria and hematuria, culminating in progression to end-stage kidney disease. Repeated kidney biopsies following eculizumab therapy demonstrated persistent, granular mesangial and capillary wall C3 (3+) staining on immunofluorescence studies, indicating ongoing complement activation upstream of the C5 blockade and the perpetuation of C3 deposits in the glomeruli. These cases underscore the limited efficacy of terminal complement inhibition in halting disease progression in C3GN.<\/jats:p>","DOI":"10.1093\/ckj\/sfag189","type":"journal-article","created":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T11:33:22Z","timestamp":1781004802000},"source":"Crossref","is-referenced-by-count":0,"title":["Long-term eculizumab treatment failure in C3 glomerulonephritis: two case reports"],"prefix":"10.1093","volume":"19","author":[{"given":"Dalia","family":"Zubidat","sequence":"first","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic College of Medicine and Science , Rochester, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3621-0766","authenticated-orcid":false,"given":"Maria Jose","family":"Soler","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic College of Medicine and Science , Rochester, MN ,","place":["USA"]},{"name":"Department of Nephrology, Vall d'Hebron University Hospital, Vall d'Hebron Institute of Research, Centro de Referencia en Enfermedad Glomerular Compleja del Sistema Nacional de Salud (CSUR) , Barcelona, Catalunya ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6104-2891","authenticated-orcid":false,"given":"Anila","family":"Cara","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic College of Medicine and Science , Rochester, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4536-7709","authenticated-orcid":false,"given":"Sanjeev","family":"Sethi","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, Mayo Clinic , Rochester, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerald B","family":"Appel","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Columbia University Medical Center , NY, NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dominick","family":"Santoriello","sequence":"additional","affiliation":[{"name":"Department of Pathology & Cell Biology, Columbia University Medical Center , NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda G","family":"Dos\u00a0Santos","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic College of Medicine and Science , Rochester, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9952-209X","authenticated-orcid":false,"given":"Fernando C","family":"Fervenza","sequence":"additional","affiliation":[{"name":"Division of Nephrology and Hypertension, Department of Medicine, Mayo Clinic College of Medicine and Science , Rochester, MN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,9]]},"reference":[{"key":"2026070711063676400_bib1","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1038\/ki.2012.63","article-title":"Acquired and genetic complement abnormalities play a critical role in dense deposit disease and other C3 glomerulopathies","volume":"82","author":"Servais","year":"2012","journal-title":"Kidney Int"},{"key":"2026070711063676400_bib2","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1038\/s41581-018-0107-2","article-title":"C3 glomerulopathy\u2014understanding a rare complement-driven renal disease","volume":"15","author":"Smith","year":"2019","journal-title":"Nat Rev 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