{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T12:12:48Z","timestamp":1789560768758,"version":"build-2803163510"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"Suppl 2","license":[{"start":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T00:00:00Z","timestamp":1775520000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Systemic sclerosis (SSc) and renal involvement most frequently present as scleroderma renal crisis (SRC). Immune complex-mediated glomerulonephritis (GN) is an exceptionally rare renal manifestation in SSc and may complicate timely diagnosis and management. We report the case of a 40-year-old woman with a history of hypertension and Raynaud\u2019s phenomenon who presented with progressive dyspnea, bilateral lower limb edema, and oliguria. Laboratory investigations demonstrated rapidly deteriorating renal function (serum urea\/creatinine \u2013 71\/6.44 mg\/dL rising to 82\/7.35 mg\/dL within 24 h), nephrotic-range proteinuria (urine protein\u2013creatinine ratio \u2248 11.6), hematuria (25\u201330 red blood cells\/high-power field), and borderline low complement C3 (80.3 mg\/dL). Autoimmune analysis revealed a speckled antinuclear antibody pattern (1:100) with Scl-70 positivity. Ultrasound showed enlarged kidneys with increased cortical echogenicity, and two-dimensional echocardiography confirmed moderate pulmonary arterial hypertension. Renal biopsy demonstrated diffuse proliferative GN with neutrophilic exudation, immunoglobulin G (IgG) and C3 immune complex deposition on immunofluorescence, and acute tubular injury, without thrombotic microangiopathy, thereby excluding SRC. The patient underwent hemodialysis and was initiated on low-dose corticosteroids. She was lost to follow-up after discharge. This case underscores an atypical and rare renal presentation of SSc, emphasizing the necessity of considering alternative diagnoses when renal dysfunction occurs without features of SRC. Early renal biopsy is essential to guide appropriate and individualized therapy in such cases.<\/jats:p>","DOI":"10.4103\/aam.aam_39_26","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T06:00:09Z","timestamp":1775541609000},"page":"S352-S355","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Immune Complex Glomerulonephritis: A Rare Presentation in Systemic Sclerosis"],"prefix":"10.4103","volume":"25","author":[{"given":"Govind S.","family":"Shiddapur","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md.","family":"Amjad","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Dr. D. Y. Patil Vidyapeeth (Deemed to be University), Pune, Maharashtra, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,4,7]]},"reference":[{"key":"R1-20260916","doi-asserted-by":"crossref","first-page":"221","DOI":"10.5114\/reum.2019.87619","article-title":"Systemic sclerosis \u2013 Multidisciplinary disease: Clinical features and treatment","volume":"57","author":"Sobolewski","year":"2019","journal-title":"Reumatologia"},{"key":"R2-20260916","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1186\/1752-1947-2-151","article-title":"Scleroderma with crescentic glomerulonephritis: A case report","volume":"2","author":"Ramaswami","year":"2008","journal-title":"J Med Case Rep"},{"key":"R3-20260916","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1038\/nrneph.2012.213","article-title":"Pathogenesis of the C3 glomerulopathies and reclassification of 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disease, and immune complex-mediated glomerulonephritis-a common clinical and histopathologic picture: Rapidly progressive crescentic glomerulonephritis","volume":"11","author":"Gluhovschi","year":"2023","journal-title":"Biomedicines"},{"key":"R11-20260916","doi-asserted-by":"crossref","first-page":"100967","DOI":"10.1016\/j.ajoc.2020.100967","article-title":"A case of systemic sclerosis\/lupus overlap syndrome presenting with bilateral cotton wool spots","volume":"20","author":"Liles","year":"2020","journal-title":"Am J Ophthalmol Case Rep"},{"key":"R12-20260916","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s12882-021-02639-w","article-title":"Systemic sclerosis complicated with renal thrombotic microangiopathy: A case report and literature review","volume":"23","author":"Kong","year":"2022","journal-title":"BMC Nephrol"},{"key":"R13-20260916","doi-asserted-by":"crossref","first-page":"1464","DOI":"10.55920\/2771-019X\/1464","article-title":"Rapidly progressive renal dysfunction in systemic sclerosis: Scleroderma renal crisis or\u2026?","volume":"3","author":"Pal","year":"2023","journal-title":"J Clin Med Img Case Rep"}],"container-title":["Annals of African Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_39_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,16]],"date-time":"2026-09-16T12:00:38Z","timestamp":1789560038000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/aam.aam_39_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,7]]},"references-count":13,"journal-issue":{"issue":"Suppl 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