Renal manifestations associated with hepatitis C virus.
Among the several types of chronic glomerulonephritis (GN) described in association with hepatitis C virus (HCV) infection, cryoglobulinemic glomerulonephritis is by far the most frequent. It is usually associated with type II cryoglobulinemia with IgM k rheumatoid factor. It is a membranoproliferative GN, which shows some distinctive histologic features (intraglomerular monocyte infiltration, intraluminal thrombi due to massive precipitation of cryoglobulins, renal vasculitis), has a chronic course with acute recurrent episodes that can be controlled by corticosteroids more than by antiviral therapy (interferon alpha). More controversial is the association with type I non-cryoglobulinemic membranoproliferative GN, which has been found in some series from the USA and Japan but not in others. The demonstration of HCV antibodies and/or HCV-RNA in other types of chronic glomerulonephritis is usually reported in a small minority of cases suggesting the possibility of a coincidental finding more than an etiologic factor.
Sinico
R A
RA
Divisione di Nefrologia e Dialisi, Azienda Ospedaliera Ospedale San Carlo Borromeo, Milano, Italy.
Fornasieri
A
A
D'Amico
G
G
D000208:Acute Disease; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D002908:Chronic Disease; D003449:Cryoglobulinemia / Q000276:immunology / Q000821:virology; D003450:Cryoglobulins / Q000145:classification; D005921:Glomerulonephritis / Q000276:immunology / Q000821:virology*; D015432:Glomerulonephritis, Membranoproliferative / Q000276:immunology / Q000473:pathology / Q000821:virology; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000150:complications*; D018937:Hepatitis C Antibodies / Q000276:immunology; D006801:Humans; D007075:Immunoglobulin M / Q000276:immunology; D007145:Immunoglobulin kappa-Chains / Q000276:immunology; D012367:RNA, Viral / Q000032:analysis; D012008:Recurrence; D012217:Rheumatoid Factor / Q000276:immunology
D000305:Adrenal Cortex Hormones; D003450:Cryoglobulins; D018937:Hepatitis C Antibodies; D007075:Immunoglobulin M; D007145:Immunoglobulin kappa-Chains; D012367:RNA, Viral; D012217:Rheumatoid Factor