{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T10:40:52Z","timestamp":1790764852623,"version":"4.1.0"},"reference-count":17,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2023,5,4]],"date-time":"2023-05-04T00:00:00Z","timestamp":1683158400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Surg Pathol"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:p>C4d is a byproduct of the activation of the classic and lectin complement pathways. Being routinely used as a marker for antibody-mediated rejection, the significance of C4d in native kidney disease is currently being widely studied. We evaluated glomerular and extraglomerular C4d staining in 82 biopsies of proliferative and nonproliferative glomerulonephritis diagnosed in our institution. The staining pattern of C4d was tabulated in various glomerular diseases. All biopsies of membranous nephropathy including membranous lupus nephritis (Class V) and immune complex-mediated membranoproliferative glomerulonephritis (MPGN) consistently showed C4d deposits along glomerular basement membrane mirroring the location of immunoglobulin and complement in these conditions. Conversely, other glomerular diseases like IgA nephropathy, postinfectious glomerulonephritis, focal segmental glomerulosclerosis, minimal change disease, and diabetic nephropathy showed variable mesangial and capillary wall C4d deposits. To summarize, the consistent pattern of C4d staining in membranous nephropathy (primary and secondary)and immune complex-mediated MPGN can be used as a valuable adjunct tool in establishing the diagnosis, especially when immunofluorescence findings are limited by inadequate sampling.C4d reactivity in other glomerular diseases are variable and may not aid as a diagnostic tool in renal biopsy evaluation.<\/jats:p>","DOI":"10.1177\/10668969231167505","type":"journal-article","created":{"date-parts":[[2023,5,5]],"date-time":"2023-05-05T01:06:30Z","timestamp":1683248790000},"page":"21-26","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Utility of C4d Immunohistochemistry as an Adjunct Stain in Diagnostic Renal Pathology of Glomerular Diseases"],"prefix":"10.1177","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9652-0179","authenticated-orcid":false,"given":"Immanuel","family":"Pradeep","sequence":"first","affiliation":[{"name":"All India Institute of Medical Sciences"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bheemanathi Hanuman","family":"Srinivas","sequence":"additional","affiliation":[{"name":"Department of Pathology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,5,4]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2014040406"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.semnephrol.2011.06.005"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2013.340"},{"issue":"2","key":"e_1_3_2_5_2","first-page":"76","article-title":"C4d immunohistochemistry in membranous nephropathy","volume":"6","author":"Hui M","unstructured":"Hui M, Uppin MS, Prayaga AK, Raju SB, Rajasekhar L. C4d immunohistochemistry in membranous nephropathy. J Lab Physicians. 2014 Jul;6(2):76.","journal-title":"J Lab Physicians."},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.15171\/jnp.2018.36"},{"issue":"2","key":"e_1_3_2_7_2","first-page":"176","article-title":"Patterns of C4d staining in patients with lupus nephritis","volume":"6","author":"Daram SR","unstructured":"Daram SR, Yalamanchili P, Salinas-Madrigal L, Bastani B. Patterns of C4d staining in patients with lupus nephritis. J Appl Res Clin Exp Therapeut. 2006 Aug 1;6(2):176.","journal-title":"J Appl Res Clin Exp Therapeut"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2014050429"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nefro.2016.05.011"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2019.04.028"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.2147\/IJNRD.S285302"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2019.02.006"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.4103\/ijn.IJN_224_20"},{"issue":"2","key":"e_1_3_2_14_2","first-page":"111","article-title":"A novel glomerular C4d scoring system: a tool to prognosticate proliferative exudative pattern of glomerular injury","volume":"31","author":"Bansode S","unstructured":"Bansode S, Gowrishankar S. A novel glomerular C4d scoring system: a tool to prognosticate proliferative exudative pattern of glomerular injury. 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