C1q nephropathy presenting as acute renal failure

We describe a 42-year-old male patient who presented with high grade fever asso-ciated with acute renal failure requiring hemodialysis. Renal biopsy revealed that he had focal proliferative glomerulonephritis on light microscopy, dominant mesangial deposition of C1q by immunofluorescent staining, and electron dense deposits on electron microscopy, with no evi-dence of systemic lupus erythematosus, compatible with the diagnosis of C1q nephropathy. Intensive treatment with a combination of methyl prednisolone pulse therapy and oral predni-solone was successful in achieving complete remission and disappearance of proteinuria in our patient.