Nephrotic syndrome after liver transplantation in a patient with hepatitis C virus-associated glomerulonephritis.
In recent years, hepatitis C virus infection has been reported to be typically associated with membranoproliferative glomerulonephritis and less frequently with membranous nephropathy. Treatment of hepatitis C with interferon-alpha can reduce viremia and improve renal disease. After liver transplantation for hepatitis C virus-associated liver failure, standard immunosuppressive protocols result in a significant increase in hepatitis C viremia. In this report we describe a patient with end-stage liver disease and biopsy-proven hepatitis C-associated glomerulonephritis who underwent liver transplantation. Within 1 month after transplantation, he developed a severe nephrotic syndrome that paralleled a marked increase in viremia. We discuss the possible pathogenic relationship between hepatitis C virus infection and the nephrotic syndrome that followed liver transplantation.
Pascual
M
M
Transplantation Unit, Massachusetts General Hospital, Boston 02114, USA.
Thadhani
R
R
Chung
R T
RT
Williams
W W
WW
Meehan
S
S
Tolkoff-Rubin
N
N
Colvin
R
R
Cosimi
A B
AB
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D003404:Creatinine / Q000097:blood; D004656:Enalapril / Q000627:therapeutic use; D005260:Female; D005921:Glomerulonephritis / Q000150:complications* / Q000821:virology; D016174:Hepacivirus / Q000302:isolation & purification; D006526:Hepatitis C / Q000150:complications* / Q000601:surgery / Q000628:therapy; D006801:Humans; D016030:Kidney Transplantation; D016031:Liver Transplantation / Q000502:physiology; D008875:Middle Aged; D009404:Nephrotic Syndrome / Q000209:etiology*; D011183:Postoperative Complications; D011507:Proteinuria; D012367:RNA, Viral / Q000097:blood; D012086:Reoperation; D013997:Time Factors; D014766:Viremia / Q000150:complications*
D000806:Angiotensin-Converting Enzyme Inhibitors; D012367:RNA, Viral; D004656:Enalapril; D003404:Creatinine