Response to high-dose interferon-alpha after failure of standard therapy in MPGN associated with hepatitis C virus infection.
A 42-year-old man developed mixed cryoglobulinemia secondary to hepatitis C virus (HCV) infection with hypocomplementemia and nephrotic syndrome. His renal biopsy showed membranoproliferative glomerulonephritis type I (MPGN). Despite treatment with interferon-alpha, three million units three times a week for a total of 6 months, the patient continued to have hypocomplementemia, cryoglobulinemia, and nephrosis. After a course of high-dose interferon-alpha treatment consisting of ten million units daily for 2 weeks followed by 10 million units three times per week for an additional 6 weeks, HCV RNA and cryoglobulin testing became negative, complement levels increased to normal levels, and nephrotic syndrome remitted. This case confirms an association between HCV infection and MPGN and suggests a role for high-dose interferon-alpha treatment when conventional interferon therapy fails.
Sarac
E
E
Department of Pathology, University of Pittsburgh Medical Center, PA 15213-2500, USA.
Bastacky
S
S
Johnson
J P
JP
D000328:Adult; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003449:Cryoglobulinemia / Q000821:virology; D004334:Drug Administration Schedule; D015432:Glomerulonephritis, Membranoproliferative / Q000188:drug therapy* / Q000821:virology; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male
D000998:Antiviral Agents; D016898:Interferon-alpha