Glomerular Deposition of Hepatitis C Virus in Membranoproliferative Glomerulonephritis

Yamabe, Hideaki; Inuma, Hiroshi; Osawa, Hiroshi; Kaizuka, Mitsuaki; Tamura, Naoyuki; Tsunoda, Satoru; Fujita, Yoshiko; Shiroto, Kennichi; Onodera, Kenji

doi:10.1159/000188987

Cited by 26 publications

(20 citation statements)

References 3 publications

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“…Only 2% of the controls (patients with noncryoglobulinemic glomerulopathies) had HCV antibodies [42] . In Japan, the virus was found in 60% patients with membranoproliferative glomerulonephritis [43] . Clinically obvious renal disease was present in 20% to 30% of cryoglobulin-positive patients with HCV infection [7,23,44] .…”

Section: Discussionmentioning

confidence: 99%

Chronic hepatitis C virus infection: Prevalence of extrahepatic manifestations and association with cryoglobulinemia in Bulgarian patients

Stefanova-Petrova¹,

Tzvetanska²,

Naumova³

et al. 2007

WJG

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AIM: To a s s e s s t h e p r e va l e n c e o f e x t ra h e p a t i c manifestations in Bulgarian patients with chronic hepatitis C virus (HCV) infection and identify the clinical and biological manifestations associated with cryoglobulinemia. METHODS:The medical records of 136 chronically infected HCV patients were reviewed to assess the prevalence of extrahepatic manifestations. Association between cryoglobulin-positivity and other manifestations were identified using χ 2 and Fisher's exact test. Risk factors for the presence of extrahepatic manifestations were assessed by logistic regression analysis. RESULTS:Seventy six percent (104/136) of the patients had at least one extrahepatic manifestation. Clinical manifestations included fatigue (59.6%), kidney impairment (25.0%), type 2 diabetes (22.8%), paresthesia (19.9%), arthralgia (18.4%), palpable purpura (17.6%), lymphadenopathy (16.2%), pulmonary fibrosis (15.4%), thyroid dysfunction (14.7%), Raynaud's phenomenon (11.8%), B-cell lymphoma (8.8%), sicca syndrome (6.6%), and lichen planus (5.9%). The biological manifestations included cryoglobulin production (37.5%), thrombocytopenia (31.6%), and autoantibodies: anti-nuclear (18.4%), anti-smooth muscle (16.9%), anti-neutrophil cytoplasm (13.2%) and anti-cardiolipin (8.8%). All extrahepatic manifestations showed an association with cryoglobulin-positivity, with the exception of thyroid dysfunction, sicca syndrome, and lichen planus. Risks factors for the presence of extrahepatic manifestations (univariate analysis) were: age ≥ 60 years, female gender, virus transmission by blood transfusions, longstanding infection (≥ 20 years), and extensive liver fibrosis. The most significant risks factors (multivariate analysis) were longstanding infection and extensive liver fibrosis. CONCLUSION:We observed a high prevalence of extrahepatic manifestations in patients with chronic HCV infection. Most of these manifestations were associated with impaired lymphoproliferation and cryoglobulin production. Longstanding infection and extensive liver fibrosis were significant risk factors for the presence of extrahepatic manifestations in HCV patients.

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Section: Discussionmentioning

confidence: 99%

Chronic hepatitis C virus infection: Prevalence of extrahepatic manifestations and association with cryoglobulinemia in Bulgarian patients

Stefanova-Petrova¹,

Tzvetanska²,

Naumova³

et al. 2007

WJG

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“…Recently a number of studies have implicated HCVinfection as the major cause of mixed cryoglobulinemia (2)(3)(4)(5)(6)(7). Patients with mixed cryoglobulinemia often showsymptoms associated with systemic vasculitis, such as purpura, arthralgia, peripheral neuropathy, and glomerulonephritis (GN).…”

Section: Introductionmentioning

confidence: 99%

Cryofiltration and Oral Corticosteroids Provide Successful Treatment for an Elderly Patient with Cryoglobulinemic Glomerulonephritis Associated with Hepatitis C Virus Infection.

et al. 2000

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A 75-year-old manwas admitted due to nephrotic syndrome, purpura on the legs, which was associated with hepatitis C virus (HCV), and type II mixed cryoglobulinemia. Renal biopsy revealed features of cryoglobulinemic glomerulonephritis. Since the patient was elderly and the HCV genotype was Ib, interferon-alpha for reducing HCVwas not indicated. Four sessions of cryofiltration and the administration of corticosteroids improved the proteinuria and renal function strikingly without adverse effects. This case demonstrates that an elderly patient who has nephrotic syndrome caused by cryoglobulinemic glomerulonephritis associated with HCVcan be treated safely by cryofiltration with low doses of oral corticosteroids.

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“…It is important to differentiate these idiopathic MPGNs from those secondary to hepatitis C infection (Table 58) (323,324). Positive serology for hepatitis C should increase the suspicion for secondary MPGN The transplant glomerulopathy that resembles MPGN and is associated with hepatitis C can occur with and without cryoglobulinemia, hypocomplementemia and rheumatoid factor (325,326). It is also important to differentiate MPGN from chronic rejection by careful histological evaluation.…”

Section: The Evaluation Of Renal Transplant Candidates: Clinical Pracmentioning

confidence: 99%

The Evaluation of the Renal Transplant Candidates: Clinical Practice Guidelines

2001

American Journal of Transplantation

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Glomerular Deposition of Hepatitis C Virus in Membranoproliferative Glomerulonephritis

Cited by 26 publications

References 3 publications

Chronic hepatitis C virus infection: Prevalence of extrahepatic manifestations and association with cryoglobulinemia in Bulgarian patients

Chronic hepatitis C virus infection: Prevalence of extrahepatic manifestations and association with cryoglobulinemia in Bulgarian patients

Cryofiltration and Oral Corticosteroids Provide Successful Treatment for an Elderly Patient with Cryoglobulinemic Glomerulonephritis Associated with Hepatitis C Virus Infection.

The Evaluation of the Renal Transplant Candidates: Clinical Practice Guidelines

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