Appearance of Nephrotic Syndrome following Interferon-α Therapy in a Patient with Hepatitis B Virus and Hepatitis C Virus Coinfection

Endo, Morito; Ohi, Hiroyuki; Fujita, Takayuki; Ohsawa, Isao; Kanmatsuse, Katsuo; Yamaguchi, Yutaka

doi:10.1159/000013367

Cited by 11 publications

(9 citation statements)

References 17 publications

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“…IFN-α therapy has been implicated in various renal diseases such as renal thrombotic microangiopathy (in patients with chronic leukemia) [12], interstitial nephritis [13], and glomerular diseases including podocytopathies (focal segmental glomerulosclerosis and minimal change disease) or immune complex glomerulonephritis (membranous nephropathy, membrano-proliferative glomerulonephritis, IgA nephropathy), as shown in several case reports published over the last 20 years [14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30]. In addition, case series have been published [31].…”

Section: Discussionmentioning

confidence: 99%

“…Additional papers provided evidence of exacerbation of pre-existing glomerular disease during IFN [32,33]. The usual presentation of glomerular disease associated with IFN is isolated proteinuria, and nephrotic syndrome [14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31]. In a minority of patients, nephritic syndrome with renal failure has been recorded.…”

Section: Discussionmentioning

confidence: 99%

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Acute Tubular Necrosis Following Interferon-Based Therapy for Hepatitis C: Case Study with Literature Review

Fabrizi

Aghemo

Fogazzi

et al. 2013

Kidney Blood Press Res

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Background/Aims: Interferon treatment of malignant or viral diseases can be accompanied by various side-effects including nephro-toxicity. Methods: We report on a 68-year-old Caucasian male who received dual therapy with pegylated interferon 2a plus ribavirin for chronic hepatitis C. Results: After three months of antiviral therapy, the patient developed acute kidney failure (serum creatinine up to 6 mg/dL) with mild proteinuria (500 mg daily) and haematuria. Immediate immunosuppressive therapy with high-dose intravenous steroids did not improve kidney function. Kidney biopsy was consistent with acute tubular necrosis without glomerular abnormalities. He started long-term peritoneal dialysis (four regular exchanges) to provide both dialysis adequacy and ascites removal. Kidney function gradually improved over the following months (serum creatinine around 2 mg/dL) and peritoneal dialysis was continued with two exchanges daily. The temporal relationship between the administration of the drug and the occurrence of nephro-toxicity, and the absence of other obvious reasons for acute tubular necrosis support a causative role for pegylated interferon; benefit on kidney disease was noted after withdrawal of antiviral agents. An extensive review of the literature on acute tubular necrosis associated with interferon-based therapy, based on in vitro data and earlier case-reports, has been made. The proposed pathogenic mechanisms are reviewed. Conclusions: Our case emphasizes the importance of monitoring renal function during treatment of chronic hepatitis C with antiviral combination therapy as treatment may precipitate kidney damage at tubular level.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Acute Tubular Necrosis Following Interferon-Based Therapy for Hepatitis C: Case Study with Literature Review

Fabrizi

Aghemo

Fogazzi

et al. 2013

Kidney Blood Press Res

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“…Of the 24 family and household contacts of the five coinfected children, 7 were infected with hepatitis B virus, 1 with hepatitis C virus, and none with both viruses. [29,30,31], HCVpositive children with MGN in this and other studies had normal complement levels and none had evidence of rheumatoid factor or cryoglobulinemia [6,9,11,12]. Moreover, none of these children had other extrahepatic manifestations that may be associated with chronic HCV infection [5].…”

Section: Resultsmentioning

confidence: 57%

“…Co-infection with HBV and HCV has not been documented in patients with MGN. To date, only one patient whose serum was positive for HBV surface antigen and antibody to HCV (anti-HCV) but not for HCV RNA has been reported to have developed MGN and the nephrotic syndrome after receiving treatment with α-interferon [12]. In addition, three patients with HCV-induced MGN had serological evidence of past HBV infection [9].…”

Section: Introductionmentioning

confidence: 99%

Hepatitis B and C virus co-infection in black children with membranous nephropathy

et al. 2002

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Membranous glomerulonephritis is a recognized complication of hepatitis B virus infection, especially in children, and an occasional complication of hepatitis C virus infection. Co-infection with the two viruses has not previously been described in membranous glomerulonephritis. We report five black African children with membranous glomerulonephritis who were co-infected with hepatitis B and C viruses. Proof of hepatitis B virus infection was obtained using serological and molecular detection methods. Hepatitis C virus infection was demonstrated using reverse transcription to convert viral RNA to cDNA followed by amplification of the cDNA using a double round of the polymerase chain reaction with confirmation by Southern hybridization and nucleotide sequencing. The clinical, biochemical, immunological, and pathological characteristics of the co-infected children, as well as the natural history of the disease, did not differ from those in 24 children with hepatitis B virus-associated membranous glomerulonephritis. Of the 24 family and household contacts of the five co-infected children, 7 were infected with hepatitis B virus, 1 with hepatitis C virus, and none with both viruses. It is not known whether infection with the two viruses was acquired simultaneously or sequentially. Thus, black children with membranous glomerulonephritis are occasionally co-infected with hepatitis B and C viruses. The resulting disease appears to be no more severe than that in children infected with hepatitis B virus alone.

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“…In fact, minimal-change nephropathy [14], focal segmental mesangial proliferation [15], focal segmental glomerulosclerosis with tubulointersticial nephritis [16], and membranous glomerulonephritis [17]have been reported due to interferon therapy.…”

Section: Discussionmentioning

confidence: 99%

Role of Ribavirin in Membranoproliferative Glomerulonephritis Associated with Hepatitis C Virus Infection Refractory to Alpha-Interferon

Pérez-Calvo¹,

Moros

Íñigo

2002

Nephron

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Chronic hepatitis C virus (HCV) has been associated with several extrahepatic diseases, such as membranoproliferative glomerulonephritis (MPGN). α-Interferon is currently the treatment of choice for this association. When this therapy fails clinicians face a difficult challenge due to the lack of useful information in these particularly difficult patients. We report the case of a severe nephrotic syndrome due to MPGN associated HCV infection, in which a triple association – interferon plus ribavirin and cyclophosphamide – was needed to control the disease.

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Appearance of Nephrotic Syndrome following Interferon-α Therapy in a Patient with Hepatitis B Virus and Hepatitis C Virus Coinfection

Cited by 11 publications

References 17 publications

Acute Tubular Necrosis Following Interferon-Based Therapy for Hepatitis C: Case Study with Literature Review

Acute Tubular Necrosis Following Interferon-Based Therapy for Hepatitis C: Case Study with Literature Review

Hepatitis B and C virus co-infection in black children with membranous nephropathy

Role of Ribavirin in Membranoproliferative Glomerulonephritis Associated with Hepatitis C Virus Infection Refractory to Alpha-Interferon

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