Cryoglobulinemia Membranoproliferative Glomerulonephritis Associated with Hepatitis C Virus

Pasquariello, Antonio; Ferri, Clodoveo; Moriconi, L; Civita, L. La; Longombardo, G.; Lombardini, Fabrizio; Greco, Francesco; Zignego, Anna Linda

doi:10.1159/000168641

Cited by 52 publications

(20 citation statements)

References 12 publications

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“…On the other hand, the nephrotic syndrome following INF-· therapy was caused by MGN with the detection of HBsAg in the glomeruli and without that of HCV, and it was strongly suggested that it was associated with HBV infection. A typical type of GN secondary to HCV infection shows membranoproliferative GN with hypocomplementemia and cryoglobulinemia [2][3][4][5]. In our patient, the renal biopsy was consistent with MGN, and neither hypocomplementemia nor cryoglobulinemia was present when the nephrotic syndrome had been developing.…”

Section: Discussionsupporting

confidence: 45%

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

et al. 1998

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A 59-year-old woman with hepatitis B surface antigen (HBsAg) and hepatitis C viral (HCV) antibody presented with proteinuria and hematuria. The patient was treated with interferon-alpha (INF-α) because plasma aminotransferase levels had been elevated and a liver biopsy had showed chronic active hepatitis. Her urinary protein excretion decreased as liver function normalized and her serum HCV-RNA was negative during treatment. Eleven weeks after completion of INF-α treatment, she suddenly presented with nephrotic-range proteinuria, although an improvement in the hepatic function was maintained. Renal pathologic findings were consistent with membranous glomerulonephritis (MGN), and HBsAg was detected in the glomeruli but not HCV. After treatment with prednisolone, her 24-hour protein excretion was below 0.7 g/day. To our knowledge this is the first report on hepatitis B virus MGN with nephrotic syndrome following IFN-α therapy for HCV. This suggests that treatment with INF-α might affect the immune processes and may be associated with the pathogenic mechanism in this patient.

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Section: Discussionsupporting

confidence: 45%

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

et al. 1998

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“…Mixed cryoglobulinaemia is relatively more frequent in Italy and Southern Europe than in other Western countries; this geographical heterogeneity suggests the contribution of other unknown infectious, genetic and environmental factors, together with a variable role of different HCV genotypes [33,44]. A multifactorial process may also be involved in the pathogenesis of other disorders frequently found in HCVpositive individuals, namely autoimmune hepatitis, porphyria cutanea tarda, autoimmune thyroiditis, membrano-proliferative glomerulonephritis, lung fibrosis, lichen planus and Mooren corneal ulcers [32,33,45,46] ( Table 2). In this light, it is more appropriate to consider chronic HCV infection as a multifaceted clinical syndrome than as a simple liver disease [32,33,35].…”

Section: Chronic Hcv Infectionmentioning

confidence: 99%

Viruses and cancers: possible role of hepatitis C virus

Ferri

Civita

Zignego

et al. 1997

Eur J Clin Investigation

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Abstract. Oncogenesis is a multifactorial process in which environmental, genetic and infectious factors are variably involved. A possible role of specific viruses has been suggested in at least 15% of human cancers. Hepatitis C virus (HCV), which is both hepato-and lymphotropic, is responsible for various liver disorders, i.e. chronic hepatitis, cirrhosis and hepatocellular carcinoma, as well as for a constellation of extrahepatic immune-mediated manifestations, among which is mixed cryoglobulinaemia. This is a systemic disorder secondary to a chronic, benign B-lymphocyte proliferation, which in some subjects may evolve to a malignant non-Hodgkin's lymphoma (NHL). Interestingly, recent studies reported the appearance of malignant B-cell neoplasias in patients with type C chronic hepatitis; moreover, in a significant number (from 22% to 50%) of 'idiopathic' NHLs, the presence of HCV infection has been demonstrated. The presence of a geographical etherogeneity in the prevalence of HCV-positive NHL suggests that other co-factors, i.e. genetic and environmental, could be involved in the lymphomagenesis. HCV may exert its oncogenic potential in two different directions, leading to liver cancer or B-cell lymphoma.

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“…Following the identification by Choo et al (1) of CDNAof hepatitis C virus (HCV) as a major cause of non-A-non-B hepatitis, several investigators have reported a relationship between HCV infection and glomerulopathies such as membranoproliferative glomerulonephritis (MPGN), membranous nephropathy (MN), and IgA nephropathy (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17). However, it is still unclear whether nephropathies are related to HCV-RNA genotypes, which are currently classified into at least four groups based on their differences in the nucleotide sequence for the core gene (18).…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological Analysis and Therapy in Hepatitis C Virus-Associated Nephropathy.

et al. 1996

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Weanalyzed the clinicopathological features and therapy in 19 patients with kidney disease accompanied by hepatitis C viral infection, including 12 patients with mesangial proliferative glomerulonephritis (including eight with IgA nephropathy), six with membranoproliferative glomerulonephritis (MPGN),and one with membranousnephropathy. Persistent hematuria and/ or proteinuria (10 patients) was the most commonfinding, followed by nephrotic syndrome (8 patients). Cryoglobulinemia was detected in six of 19 patients examined (four of six patients with MPGN).Analysis of hepatitis C virus (HCV)-RNAgenotype in 13 patients revealed that nine of them had type II genotype. All four patients with MPGN, who had serum positive for HCV-RNA, had type II genotype. Five patients were treated with interferon-a (IFN-a) without a demonstrable effect on renal impairment, whereas five of ll patients treated with steroids showed improvement of the renal impairment. During the course of steroid therapy, the serum titer of HCV-RNA decreased in 5 of7 patients. These observations suggest that HCVinfection may be associated with several forms ofglomerulonephritis. Type II HGV-RNA mayhave a strong association with MPGN in Japan. Steroid therapy is not contraindicated in patients with HCV-associated nephropathy if they are resistant to IFN-a treatment.

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Cryoglobulinemia Membranoproliferative Glomerulonephritis Associated with Hepatitis C Virus

Cited by 52 publications

References 12 publications

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

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

Viruses and cancers: possible role of hepatitis C virus

Clinicopathological Analysis and Therapy in Hepatitis C Virus-Associated Nephropathy.

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