1/33. alpha-Interferon therapy for HBV-related glomerulonephritis.We report a case of a patient with hepatitis b virus (HBV)-related membranous glomerulonephritis (MGN) who showed improvement after interferon-alpha (IFN-alpha) therapy. A 35-year-old man with nephrotic syndrome and HBV antigens received a 24-week course of IFN-alpha. At the end of therapy there was an elevation in the level of plasma aminotransferase and an increase in proteinuria, which were followed by antigen/antibody seroconversion. This "flare-up" before seroconversion suggests an increase in disease activity in the liver and kidney, demonstrating in vivo HBV involvement in MGN.- - - - - - - - - - ranking = 1keywords = hepatitis (Clic here for more details about this article) |
2/33. role of interferon-alpha in the treatment of primary glomerulonephritis.interferon-alpha (IFN-alpha) is a naturally occurring cytokine. It was the first cytokine used with clinical benefit in the treatment of viral hepatitis and malignancies. patients with viral hepatitis B or C may have complications with glomerulonephritis (GN). Improvement in proteinuria with or without clearing of viral markers after IFN-alpha therapy has been reported. This encouraged us to offer IFN-alpha therapy to four patients with GN. These patients refused treatment with steroids and/or cyclophosphamide because of concerns about side effects. One patient with membranous GN and two patients with mesangial GN (MesGN) had a remission of nephrotic syndrome. In one patient with type II diabetes and MesGN, renal insufficiency and proteinuria did not subside; however, renal function remained stable. The mechanism of action of IFN-alpha is discussed, with its possible role in the treatment of primary GN.- - - - - - - - - - ranking = 2keywords = hepatitis (Clic here for more details about this article) |
3/33. Transformation of hepatitis b virus-related membranous glomerulonephritis to crescentic form.We report a case of hepatitis b virus-(HBV) related membranous glomerulonephritis which progressed to crescentic transformation after withdrawal of immunosuppressive treatment. Immunosuppressive therapy probably enhanced HBV replication, and its withdrawal led to a return of immune competence resulting in progression of the glomerulonephritis. Prior screening of all patients for hepatitis B surface antigen, before using immunosuppressive therapy may prevent this complication. The usage of immunosuppressive therapy as a first-line choice in HBV-related glomerulonephritis may result in harmful complications.- - - - - - - - - - ranking = 6keywords = hepatitis (Clic here for more details about this article) |
4/33. Autoimmune hepatitis with membranous glomerulonephritis.We report on a case of autoimmune hepatitis (AIH) associated with membranous glomerulonephritis. A 61-year-old woman was admitted because of peripheral edema, proteinuria and abnormal liver function test findings. A diagnosis of AIH was made on the basis of an elevation of aminotransferase and serum IgG levels, the presence of positive antinuclear antibody and the characteristic histological features of chronic active hepatitis. Histological examination of a renal biopsy specimen disclosed membranous glomerulonephritis with granular deposits of IgG, IgM, C3 and C1q along the capillary walls. This condition is rare in AIH and should be carefully distinguished from systemic lupus erythematosus.- - - - - - - - - - ranking = 6keywords = hepatitis (Clic here for more details about this article) |
5/33. A case of mixed membranous nephropathy and purpura nephritis.We report the case of a 71-year-old man with mixed glomerular lesions, membranous and necrotizing changes. The patient had abdominal pain and purpurat on the extremities and trunk, followed by melena, and after admission to hospital, proteinuria and occult blood were noted. Laboratory findings were negative for autoimmune disease and viral hepatitis. Renal biopsy showed segmental necrotizing changes and mesangial proliferation with spike formation. Immunofluorescence revealed a granular deposition of IgA predominantly in the mesangial area in contrast to the granular IgG deposition along the glomerular capillary loops. Moreover, electron-microscopically, mesangial as well as subepithelial electron-dense deposits were observed. These data suggest that the patient had 2 distinct types of glomerulonephritis simultaneously: idiopathic membranous nephropathy and purpura nephritis.- - - - - - - - - - ranking = 1keywords = hepatitis (Clic here for more details about this article) |
6/33. HBV associated nephrotic syndrome: resolution with oral lamivudine.A 6 year old boy presenting with a five month history of fever, lethargy, and anorexia, was found to have hepatitis B associated membranous glomerulonephropathy and nephrotic syndrome. After two months treatment with oral lamivudine, his proteinuria cleared and serum albumin and aminotransferases normalised, associated with disappearance of hepatitis B e antigen (HBeAg) and appearance of anti-HBeAg antibodies. After 12 months, without side effects, lamivudine was discontinued. He remains well 11 months off treatment.- - - - - - - - - - ranking = 2keywords = hepatitis (Clic here for more details about this article) |
7/33. Interferon treatment for hepatitis B-associated membranous glomerulonephritis in two Chinese children.Two Chinese boys, aged 3.5 and 5 years, developed nephrotic syndrome and were chronic carriers of hepatitis b virus surface antigen (HBsAg) and hepatitis b virus e antigen (HBeAg). Renal biopsy showed membranous glomerulonephritis and liver biopsy showed chronic persistent hepatitis. They were given interferon-alpha-2a at a dose of 5 MU/m2 on alternate days for 12 and 16 weeks after 2 years of persistent nephrotic syndrome. Patient 1 showed complete remission and resolution of hepatosplenomegaly, but his serum remained positive for HBsAg, HBeAg and hepatitis b virus dna. Patient 2 showed only a transient clinical response and seroconversion from HBeAg to anti-HBe status. Although not always successful, interferon treatment should be considered in severe persistent nephrotic states, since there is at present no satisfactory treatment for this form of glomerulonephropathy.- - - - - - - - - - ranking = 8keywords = hepatitis (Clic here for more details about this article) |
8/33. Membranous glomerulonephritis associated with hepatitis c virus infection: case report and literature review.We describe the case of a 51-year-old man with hepatitis c virus (HCV) infection and a 3-month history of facial edema. Laboratory tests upon admission for renal biopsy showed normal renal function and normocomplementemia. Serum HCV antibody (Ab) and cryoglobulin were positive. Renal biopsy specimens showed features of membranous glomerulonephritis. The likely cause was immune complex-mediated glomerulonephritis associated with HCV infection. Reports of similar cases in the literature show the normocomplementemia and negative or slightly positive cryoglobulins observed in our case as well as seropositivity for circulating immune complexes containing HCV rna. In our case, electron microscopic examination of the subepithelial glomerular lesions revealed massive virus-like particles within unusual multilayers of electron-dense deposits (EDDs), suggesting the existence of HCV in the glomeruli. In the addition to the unique histopathological feature the presence of La/SS-B antibody in his serum indicated an abnormal immune response associated with HCV. We advise him to undergo the therapy with new type of IFN such as pegIFN-alpha2a and/or anti-viral agent like ribavirin to achieve clinical and histopathological improvement.- - - - - - - - - - ranking = 5keywords = hepatitis (Clic here for more details about this article) |
9/33. ribavirin monotherapy for hepatitis c virus-associated membranous nephropathy.Glomerular diseases associated with hepatitis c virus (HCV) infection are increasingly being recognized. Antiviral therapy with interferon-alpha (IFN-alpha) and ribavirin eradicate viral activity in a significant proportion of patients with chronic active hepatitis, often with amelioration of extrahepatic manifestations, including glomerular pathology. Unfortunately, adverse effects often preclude the use of IFN-alpha. We describe a patient with refractory nephrotic syndrome secondary to HCV-associated membranous nephropathy who sustained a complete remission following the initiation of ribavirin monotherapy. The existing literature on the association between these two disorders and therapy with ribavirin is reviewed.- - - - - - - - - - ranking = 6keywords = hepatitis (Clic here for more details about this article) |
10/33. lamivudine for the treatment of membranous glomerulopathy secondary to chronic Hepatitis B infection.Membranous glomerulopathy is a well-recognized extrahepatic manifestation of chronic hepatitis b virus (HBV) infection. The authors report two cases of HBV-related nephrotic syndrome treated with lamivudine. A 46-year-old Chinese man had a hepatitis B e antigen seroconversion along with improvement in his nephrotic syndrome after lamivudine therapy. Two years after treatment was discontinued, a reactivation of HBV was successfully treated again with lamivudine. A 44-year-old Chinese woman, who was intolerant of interferon, was treated with lamivudine for 15 months without a virological response. However, two years after completing lamivudine, her nephrotic syndrome resolved. Implications for the treatment of HBV-related glomerulopathy and a review of the literature are presented.- - - - - - - - - - ranking = 2keywords = hepatitis (Clic here for more details about this article) |
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