Membranous nephropathy associated with hepatitis B in Spanish children.
OBJECTIVE
To examine retrospectively long-term evolution and treatment of pediatric membranous nephropathy (MN) cases associated with hepatitis B (HB) in the hospital "La Paz".


METHODS
The clinical records of 12 children diagnosed with HB-associated MN in our hospital between 1970 and 1996.


RESULTS
All patients were positive for hepatitis B surface antigen (HBsAg); 6 were tested for hepatitis Be antigen (HBeAg) and were also positive. At onset, all of them had proteinuria (8 in nephrotic range), 6 had microscopic hematuria and 4 macroscopic hematuria. Seven of 8 children who started with a nephrotic syndrome received steroids and all of them were steroid-resistant. After 9.95 +/- 5.88 years of follow-up, renal function remained normal and proteinuria and hematuria have disappeared in all of them. A family study for hepatitis B was carried out in 8 cases and 7 of them were positive. Only in one case vertical transmission was demonstrated; this patient remained HBeAg positive. In 7 patients, hepatic biopsy was performed: 3 had a chronic active hepatitis, 3 a persistent chronic hepatitis and one a residual acute hepatitis.


CONCLUSIONS
Membranous nephropathy is a rare pediatric disease in our area and most of the cases are related to hepatitis B (HB). The outcome was excellent with and without treatment but all of them remained HBsAg positive.
Peña
A
A
Department of Paediatric Nephrology, Hospital Infantil La Paz, Madrid, Spain. apena@hulp.es
Débora
M J
MJ
Melgosa
M
M
Luz Picazo
M
M
Navarro
M
M
D002648:Child; D002675:Child, Preschool; D005260:Female; D015433:Glomerulonephritis, Membranous / Q000150:complications* / Q000175:diagnosis; D006509:Hepatitis B / Q000150:complications* / Q000175:diagnosis / Q000635:transmission; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006513:Hepatitis B e Antigens / Q000032:analysis; D006801:Humans; D008297:Male; D009404:Nephrotic Syndrome / Q000150:complications; D012189:Retrospective Studies; D013030:Spain
D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens