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[Two cases of membranous glomerulonephritis associated with hepatitis C virus infection]
Y Takishita1, S Ishikawa, K Okada
1Department of Internal Medicine, Tokushima Prefectural Central Hospital, Japan.
Abstract:
Although the occasional occurrence of glomerulonephritis associated with hepatitis C virus (HCV) infection has been reported recently in the literature, the type described has been mainly membranoproliferative glomerulonephritis (MPGN); membranous glomerulonephritis (MGN) is very rare. In this paper, two cases of MGN associated with HCV infection are reported. Case 1 was a 56-year-old male who had positive HCV Ab and HCV RNA. The diagnosis of chronic active hepatitis was verified by liver biopsy. Laboratory data showed proteinuria (5g per day), hematuria and hypocomplementemia by hemolytic assay. Renal biopsy led to the diagnosis of MGN in stage II. The patient was treated with interferon alpha for 6 months, resulting in improvement of hypocomplementemia, transient reduction of GOT and GPT during the course of treatment. The GOT and GPT were aggravated again after the completion of therapy. No improvement was seen in proteinuria and hematuria, and HCV Ab remained positive. Case 2 was a 69-year-old male who had positive HCV Ab and HCV RNA, and had normal liver function. Subsequently, his GOT value was slightly elevated. Proteinuria (2g per day) was demonstrated. The diagnosis of MGN in stage II was made on the basis of renal biopsy. The clinical characteristics of these two cases suggest that MGN is a type of glomerulonephritis associated with HCV infection.
Insights
Hepatitis C virus (HCV) infection can cause membranous glomerulonephritis (MGN), a rare kidney disease. This study reports two cases of MGN linked to HCV, highlighting a potential association between the virus and this specific kidney condition.
Area of Science:
- Nephrology
- Hepatology
- Virology
Background:
- Hepatitis C virus (HCV) infection is occasionally linked to glomerulonephritis.
- Membranoproliferative glomerulonephritis (MPGN) is the most commonly reported type.
- Membranous glomerulonephritis (MGN) associated with HCV is considered very rare.
Observation:
- Two male patients, aged 56 and 69, presented with positive HCV antibodies and HCV RNA.
- Both patients were diagnosed with stage II MGN via renal biopsy.
- Case 1 showed significant proteinuria, hematuria, and hypocomplementemia, with transient improvement after interferon alpha treatment.
- Case 2 presented with proteinuria and normal liver function initially, with a later slight elevation in GOT.
Findings:
- The clinical presentation and biopsy results in both cases support MGN as a manifestation of HCV infection.
- Interferon alpha treatment showed limited long-term efficacy in resolving proteinuria and hematuria in the reported cases.
- Persistent HCV infection was noted in both patients.
Implications:
- These cases suggest that MGN should be considered in the differential diagnosis of kidney disease in patients with HCV infection.
- Further research is warranted to understand the pathogenic mechanisms linking HCV to MGN.
- Exploring novel therapeutic strategies for HCV-associated MGN may be beneficial.