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Membranous glomerulonephritis associated with hepatitis B antigen in children: a comparison with idiopathic
Abstract:
The laboratory and pathological findings are reported for 16 children with membranous glomerulonephritis (MGN) associated with hepatitis B virus (HBV) infection and compared with those of 12 children with idiopathic MGN. Serum hepatitis B surface antigen (HBsAg) was found in all children with HBV associated MGN and serum hepatitis B e antigen (HBeAg) in 11 of the 15 examined. Five patients with HBV associated MGN, but none with idiopathic MGN, showed reduced serum C3 values. Otherwise there was no difference in laboratory findings. HBeAg was detected in the glomeruli of all 7 patients with HBV-associated MGN examined but HBsAg was not detected. Of the 14 children with HBV-associated MGN examined by electron microscopy, all but one showed small mesangial deposits and 4 subendothelial deposits, whereas of 9 with idiopathic MGN only 2 showed mesangial deposits and none subendothelial deposits. Thus most of the children with HBV-associated MGN are characterized by some laboratory and pathological features of membrano proliferative glomerulonephritis in addition to those of idiopathic MGN. These observations are consistent with HBV inducing a spectrum of glomerulopathy from typical MGN to typical membranoproliferative glomerulonephritis.
Insights
Hepatitis B virus (HBV) infection in children with membranous glomerulonephritis (MGN) presents distinct laboratory and pathological features, often resembling membranoproliferative glomerulonephritis. These findings suggest HBV can cause a spectrum of kidney disease.
Area of Science:
- Nephrology
- Virology
- Pediatric Pathology
Background:
- Membranous glomerulonephritis (MGN) is a significant cause of nephrotic syndrome in children.
- Hepatitis B virus (HBV) infection is a known extrahepatic manifestation of HBV.
- The spectrum of kidney disease associated with HBV infection is not fully elucidated in pediatric populations.
Purpose of the Study:
- To compare the laboratory and pathological findings of pediatric MGN associated with HBV infection versus idiopathic MGN.
- To characterize the specific renal pathology induced by HBV in children.
- To understand the range of glomerulopathies caused by HBV infection.
Main Methods:
- Retrospective analysis of laboratory data and kidney biopsy findings.
- Comparison of 16 children with HBV-associated MGN and 12 children with idiopathic MGN.
- Detection of hepatitis B antigens (HBsAg, HBeAg) in serum and renal tissue.
- Electron microscopy examination of glomerular deposits.
Main Results:
- All HBV-associated MGN cases showed positive serum HBsAg and HBeAg in most cases.
- Reduced serum C3 levels were observed in 5 HBV-associated MGN patients, but not in idiopathic MGN.
- Glomerular HBeAg was detected in HBV-associated MGN, while HBsAg was not.
- Electron microscopy revealed mesangial and subendothelial deposits more frequently in HBV-associated MGN.
Conclusions:
- Pediatric HBV-associated MGN exhibits distinct laboratory and pathological features, often overlapping with membranoproliferative glomerulonephritis.
- HBV infection can induce a spectrum of glomerulopathy, ranging from typical MGN to membranoproliferative patterns.
- These findings highlight the importance of screening for HBV in children presenting with MGN.