{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T19:04:45Z","timestamp":1783191885285,"version":"3.54.6"},"reference-count":17,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Glomerular Dis"],"abstract":"<jats:p>Immune complex-mediated membranoproliferative glomerulonephritis (IC-MPGN) lacks proven targeted therapy and is often refractory to nonspecific immunosuppression. Dysregulation of the alternative complement pathway provides a mechanistic rationale for proximal C3 inhibition. This article presents our experience with the management of a case of refractory IC-MPGN with the C3 inhibitor, pegcetacoplan. A 19-year-old man presented with nephrotic-range proteinuria, haematuria, hypoalbuminaemia (20 g\/L), and depressed complement (C3 0.06\u20130.14 g\/L with normal C4). Kidney biopsy demonstrated IC-MPGN with granular IgA\/IgG\/C3 along capillary loops and electron-dense deposits in subendothelial, intramembranous, and subepithelial locations. Despite treatment with corticosteroids and tacrolimus, disease activity persisted, prompting initiation of pegcetacoplan 1,080 mg subcutaneously twice weekly. The urine protein-creatinine ratio (UPCR) decreased to 751 mg\/g (\u221270% from baseline), and 24-h urinary protein excretion declined to 1,386 mg\/day (\u221283%). Serum albumin increased from 20 to 36 g\/L, while serum creatinine remained stable (92 \u00b5mol\/L). Complement levels normalised, with C3 rising from 0.06 g\/L to 1.27 g\/L, permitting discontinuation of antihypertensive and immunosuppressive medications. No adverse events were observed. This case supports C3-targeted therapy with pegcetacoplan to achieve rapid biochemical and clinical remission in refractory IC-MPGN. Longer follow-up with histologic correlation and biomarker-guided selection is needed to define durability and responders.<\/jats:p>","DOI":"10.1159\/000551111","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T17:01:12Z","timestamp":1772211672000},"page":"84-93","source":"Crossref","is-referenced-by-count":1,"title":["Successful Treatment of Refractory Immune Complex-Mediated Membranoproliferative Glomerulonephritis with Pegcetacoplan: A Case Report"],"prefix":"10.1159","volume":"6","author":[{"given":"Abdullah","family":"Al-Muhaiteeb","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anas","family":"Al Yousef","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad","family":"Altaleb","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2021.05.021"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2024.09.017"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2024.11.018"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfad182"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1159\/000542354"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2020.00205"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1080\/17474086.2024.2440101"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2023.08.033"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2024.09.030"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2023.12.007"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.c.31986"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2021.05.015"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2020.09.019"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1111\/nep.70001"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-021-01560-8"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020005959"},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1016\/j.clim.2018.09.004"}],"container-title":["Glomerular Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/000551111","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T16:00:56Z","timestamp":1777046456000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000551111"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,27]]},"references-count":17,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000551111","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.31429178","asserted-by":"subject"}]},"ISSN":["2673-3633"],"issn-type":[{"value":"2673-3633","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,27]]}}}