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[Chronic hepatitis caused by B virus and glomerulonephritis in children]
P Jara Vega1, C Camarena Grande, M C Díaz Fernández
1Unidad de Gastroenterología, Hospital Infantil La Paz, Madrid.
Insights
Chronic hepatitis B (HBV) infection is frequently associated with kidney disease (glomerulonephritis) in children. Investigating liver function is crucial for diagnosing HBV in pediatric patients with glomerulonephritis.
Area of Science:
- Pediatric Nephrology
- Hepatology
- Infectious Diseases
Context:
- Glomerular disease is a significant health concern in children.
- Hepatitis B virus (HBV) infection can manifest with extrahepatic complications.
- The association between HBV and glomerulonephritis (GN) in pediatric populations requires further elucidation.
Purpose:
- To investigate the prevalence and characteristics of HBV infection in children diagnosed with glomerular disease.
- To determine the specific types of glomerulonephritis associated with chronic HBV infection in pediatric patients.
- To highlight the importance of HBV screening in children presenting with nephropathy.
Summary:
- This study examined eight children (1-9 years) with chronic HBV hepatitis and glomerular disease.
- Patients presented with various forms of GN, including membranous nephropathy, mesangial proliferative GN, and mesangial GN, often linked to chronic persistent hepatitis (CPH) or chronic active hepatitis (CAH).
- Hepatitis B surface antigen (HBsAg) and anti-hepatitis B core antibody (anti-HBc) were detected in all patients, with renal HBsAg deposits identified in one case, underscoring the link between HBV and kidney pathology.
Impact:
- Findings suggest a strong association between HBV infection and glomerulonephritis in children.
- Recommends routine liver function tests and HBV screening for pediatric patients with unexplained glomerular disease.
- Emphasizes the need for early diagnosis and management of HBV to prevent or mitigate renal complications.
Abstract:
Eight children with chronic HBV hepatitis and glomerular disease were studied. There were seven males and one female, with ages between one and nine years old. Three had CPH and five CAH. All patients with CPH had membranous nephropathy, and those with CAH three had MNG. one membranoproliferative glomerulonephritis and one mesangial glomerulonephritis. Only six patients had moderate liver enlargement. In all, the diagnosis of HBV infection was performed by investigation of the etiology of their nephropathy. Liver function test showed signs of moderate necrobiosis with impaired biliary acid metabolism. All were HBsAg (+), antiHBc (+), six were antiHBe (+) and two were HBeAg (+). In one case renal deposit of HBsAg was found. Due to the frequent association of HBsAg and glomerulonephritis (GN) in children, an investigation of liver function is highly recommended in those patients with GN a HBV infection.