C4A and lobular neoplasia: On biopsy, distinguishing glomerular complement fractions via C1q/C3 staining may be informative as in a subset of LN patients, an activation of the alternative complement pathway that sustains inflammation (histology C3+/C1q− and normal serum complement C3/C4/CH50 levels) is associated with a less active disease but with a more progressive disease that affects therapeutic response and ESKD evolution [19,20].