CD46 and hyperinsulinemic hypoglycemia, familial, 4: During a median of 36 months follow-up (IQR = 12–72 months), 11 patients with anti-FHs experienced relapses of the disease (37%): 9 had the FHR1 deficiency, one the FHR1 deficiency plus a LPV in CFH and one a LPV in CD46 and 1 copy of CFHR1. Overall, 15 patients (50%) developed end stage renal disease (ESRD): 8 had the FHR1 deficiency, 2 the FHR1 deficiency plus a LPV in C3 and CFH, respectively and 2 a LPV in THBD (and 1 copy of CFHR1) and C3 (and 2 copies of CFHR1), respectively.