Immune mediated crescentic MPGN secondary to HBV infection: A rare presentation for a common infection

Mareddy, Aswani Srinivas; Rangaswamy, Dharshan; Vankalakunti, Mahesha; Attur, Ravindra Prabhu; Nagaraju, Shankar Prasad; Neeraja, Koti

doi:10.4066/amj.2015.2568

Cited by 6 publications

(5 citation statements)

References 15 publications

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“… 14 These patients require long-term oral antivirals. 12 , 16 Plasma exchange, steroids and immunosuppressants can be used when there are severe complications, such as reduced renal function. 14 This current patient was HBV-positive and the blood globulin level was positive.…”

Section: Discussionmentioning

confidence: 99%

Hepatitis B virus-associated cryoglobulinaemia diffuse endocapillary proliferative glomerulonephritis: a case report and literature review

Han

2022

J Int Med Res

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Cryoglobulinaemia can manifest as fatigue, purpura, and joint pain, and can involve the kidneys and peripheral nervous system. Type II and mixed cryoglobulinemia cases are usually associated with hepatitis C virus infection and autoimmune diseases, and most cases reported outside China have been related to hepatitis C virus. The pathological manifestation of cryoglobulinaemia glomerulonephritis is always membranous proliferative glomerulonephritis or membranous nephropathy; other pathological types are rare. This current case report describes a female patient with hepatitis B virus (HBV)-associated cryoglobulinaemic glomerulonephritis. The patient had hepatitis B complicated with purpura, abnormal urinalysis and renal function. She was positive for rheumatoid factor and had decreased complement, and her blood cryoglobulin level was positive. The pathological findings were consistent with late-stage capillary proliferative glomerulonephritis, which improved after steroid, immunosuppressant and anti-HBV treatment.

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Section: Discussionmentioning

confidence: 99%

Hepatitis B virus-associated cryoglobulinaemia diffuse endocapillary proliferative glomerulonephritis: a case report and literature review

Han

2022

J Int Med Res

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“…It is important to differentiate primary NM from HBV-MN because immunosuppressive treatment exacerbates the infection in HBV-infected patients. Other morphological rarer patterns such as membranoproliferative glomerulonephritis (MPGN), minimal change disease (MCD), and IgA nephropathy have been described [ 50 ].…”

Section: Viral Infections and Glomerulonephritismentioning

confidence: 99%

Autoimmunity and Infection in Glomerular Disease

Casuscelli,

Longhitano,

Maressa

et al. 2023

Microorganisms

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The ongoing glomerular damage of infections is not limited to the most widely known form of post-streptococcal glomerulonephritis, which is today less common in the Western world; other forms of glomerulonephritis are associated with several bacterial, viral and parasitic pathogens. The mechanisms responsible range from the direct damage of glomerular cells to the formation and deposition of immunocomplexes to molecular mimicry to the secretion of superantigens. Similarly, in the course of glomerular disease, infections are more frequent than in the general population due to the loss of immunoglobulins in urine and the immunosuppressive agents used to treat the autoimmune disease that decrease the activity of the immune system. Recognizing this two-way link, understanding its pathogenetic mechanism, and identifying the most appropriate therapeutic choice are essential for the personalized management of patients. In this continuously developing field, this short review summarizes the current state of the art as support for physicians, who are increasingly involved in managing patients with glomerular disease and infections.

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“…Mareddy et al also presented a case of 44-year-old man with chronic HBV infection do presented with rapidly progressive kidney failure and nephrotic syndrome and was found to have crescentic MPGN on kidney biopsy. 12 They also treated the patient with multimodal therapy including steroids, antivirals and plasmapheresis and succeeded in achieving kidney and virological remission. In the present case, because the patient presented with RPGN and kidney biopsy showing crescentic MPGN, he was managed with intravenous methylprednisolone along with entecavir and plasma exchange to reduce the immune complex deposits.…”

Section: Case Reportmentioning

confidence: 99%

Chronic hepatitis B virus (HBV) infection presenting as crescentic membranoproliferative glomerulonephritis: A distinctly rare occurrence

Mubarak¹,

Jafry

Khan

et al. 2021

Pak J Kidney Dis

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Abstract Hepatitis B virus (HBV) is a highly prevalent infection worldwide. It primarily infects liver and presents with features of chronic liver disease. Rarely, it presents with extra-hepatic manifestations. Kidney involvement in HBV infection is not uncommon. However, presentation with rapidly progressive glomerulonephritis is distinctly rare. A 40-year-old man with undiscovered HBV infection presented with fever-triggered body swelling for one month. Serum creatinine was 2.3 mg/dl on admission, which increased during hospitalization to 4.5 mg/dl. Renal biopsy demonstrated crescentic membranoproliferative glomerulonephritis, immune complex-mediated. Clinical, laboratory and imaging studies revealed mild chronic liver damage. Complete renal, hepatic and virological remission was achieved with steroids, plasmapheresis and antiviral therapy. This case emphasizes on early diagnosis and institution of multimodal therapy for better outcomes.

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Immune mediated crescentic MPGN secondary to HBV infection: A rare presentation for a common infection

Cited by 6 publications

References 15 publications

Hepatitis B virus-associated cryoglobulinaemia diffuse endocapillary proliferative glomerulonephritis: a case report and literature review

Hepatitis B virus-associated cryoglobulinaemia diffuse endocapillary proliferative glomerulonephritis: a case report and literature review

Autoimmunity and Infection in Glomerular Disease

Chronic hepatitis B virus (HBV) infection presenting as crescentic membranoproliferative glomerulonephritis: A distinctly rare occurrence

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