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Kidney glomerular pathology in various forms of acute and chronic hepatitis
Insights
Hepatitis B virus infection can lead to kidney damage. This study found hepatitis B surface antigen immune deposits in the kidneys of patients with hepatitis and liver cirrhosis, suggesting a link between viral infection and glomerular disease.
Area of Science:
- Nephrology
- Hepatology
- Immunology
Background:
- Hepatitis B virus (HBV) infection is a global health concern.
- Kidney involvement in HBV infection is not fully understood.
- Liver cirrhosis and hepatitis are associated with various extrahepatic manifestations.
Purpose of the Study:
- To investigate the presence and characteristics of kidney glomerular deposits in patients with hepatitis and liver cirrhosis.
- To determine the association between hepatitis B virus infection and renal pathology.
Main Methods:
- Histological examination of kidney tissue from 99 necropsy cases.
- Direct immunofluorescence to detect immune deposits.
- Analysis of cases with acute/subacute hepatitis and chronic aggressive hepatitis/liver cirrhosis.
Main Results:
- Hepatitis B surface antigen (HBsAg), IgG, IgM, and complement deposits were identified in the glomeruli of 15% of acute/subacute hepatitis cases and 17% of chronic hepatitis/cirrhosis cases.
- Deposits were granular and located in mesangial areas and/or along capillary walls.
- Associated glomerular lesions included capillary wall thickening, increased cellularity, and mesangial matrix expansion.
Conclusions:
- Hepatitis B virus infection is associated with immune complex deposition in the kidneys.
- These immune deposits and resulting glomerular lesions may arise from the immune clearance of circulating HBsAg-containing immune complexes.
- HBV infection should be considered in the differential diagnosis of glomerular diseases.
Abstract:
Kidney tissue from 99 unselected necropsy cases of various forms of hepatitis and liver cirrhosis was examined by histology and direct immunofluorescence. Glomerular deposits of hepatitis B surface antigen (HBsAg), IgG, IgM, and complement were found in nine of 59 cases (15%) of acute and subacute hepatitis and in seven of 40 cases (17%) of chronic aggressive hepatitis and liver cirrhosis. Different amounts of granular hepatitis B surface antigen immune deposits were distributed along glomerular capillary walls and/or in mesangial areas. Glomerular lesions found in these cases consisted of thickening of glomerular capillary walls, a slight increase in glomerular cellularity, and an increase of mesangial matrix. These glomerular lesions are considered to result from the humoral immune elimination of circulating viral surface antigen immune complexes.