Successful steroid treatment in a patient with membranoproliferative glomerulonephritis associated with hepatitis C virus
Autor: | Toru Sanai, Kohsuke Masutani, Mitsuo Iida, Masaru Nakayama, Hironori Sakai, Noriko Uesugi, Izumi Watanabe, Tadashi Hirano, Hideki Hirakata, Ritsuko Katafuchi |
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Rok vydání: | 2008 |
Předmět: |
medicine.medical_specialty
Glomerulonephritis Membranoproliferative Prednisolone Urology Gastroenterology Internal medicine Membranoproliferative glomerulonephritis medicine Humans Hypoalbuminemia Glucocorticoids Aged Hepatitis medicine.diagnostic_test business.industry Remission Induction Glomerulonephritis Hepatitis C Hepatitis C Chronic medicine.disease Cryoglobulinemia Nephrology Immunology Mesangial proliferative glomerulonephritis Female Renal biopsy business |
Zdroj: | International Urology and Nephrology. 41:179-183 |
ISSN: | 1573-2584 0301-1623 |
DOI: | 10.1007/s11255-007-9322-7 |
Popis: | Thirteen years ago, a 65-year-old woman was diagnosed to have chronic active hepatitis with hepatitis C virus. After starting interferon alpha administration, she noticed edema and hypoalbuminemia. Renal biopsy revealed mesangial proliferation with focal endocapillary proliferation, and double contour of the glomerular basement membrane due to mesangial interposition. Interferon alpha was discontinued, and proteinuria and edema gradually decreased. She was re-admitted due to a relapse of proteinuria 8 years later. Biopsy revealed moderate mesangial and endcapillary proliferation presenting a lobular pattern, in addition to the presence of hyaline thrombi. Granular staining of immunoglobulin M and of C3 in capillary walls were detected. Since cryoglobulinemia was positive, a final diagnosis of cryoglobulinemic membranoproliferative glomerulonephritis was made. Prednisolone was started with an initial dose of 20 mg/day. Proteinuria and hypoalbuminemia improved, and prednisolone was tapered to 5 mg/day 9 months after the 2nd renal biopsy. The hepatitis C virus-RNA titer fluctuated. |
Databáze: | OpenAIRE |
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