title: Successful steroid treatment in a patient with membranoproliferative glomerulonephritis associated with hepatitis C virus.
abstract: Thirteen years ago, a 65-year-old woman was diagnosed to have chronic active hepatitis with hepatitis C virus. After starting interferon alpha administration, she noticed edema and hypoalbuminemia. Renal biopsy revealed mesangial proliferation with focal endocapillary proliferation, and double contour of the glomerular basement membrane due to mesangial interposition. Interferon alpha was discontinued, and proteinuria and edema gradually decreased. She was re-admitted due to a relapse of proteinuria 8 years later. Biopsy revealed moderate mesangial and endcapillary proliferation presenting a lobular pattern, in addition to the presence of hyaline thrombi. Granular staining of immunoglobulin M and of C3 in capillary walls were detected. Since cryoglobulinemia was positive, a final diagnosis of cryoglobulinemic membranoproliferative glomerulonephritis was made. Prednisolone was started with an initial dose of 20 mg/day. Proteinuria and hypoalbuminemia improved, and prednisolone was tapered to 5 mg/day 9 months after the 2nd renal biopsy. The hepatitis C virus-RNA titer fluctuated.
authors.affiliation: Division of Nephrology, National Kyushu Medical Center, Fukuoka, Japan. sunny@cc.saga-u.ac.jp
authors.forename: Toru
authors.initials: T
authors.lastname: Sanai
authors.forename: Izumi
authors.initials: I
authors.lastname: Watanabe
authors.forename: Tadashi
authors.initials: T
authors.lastname: Hirano
authors.forename: Masaru
authors.initials: M
authors.lastname: Nakayama
authors.forename: Hironori
authors.initials: H
authors.lastname: Sakai
authors.forename: Noriko
authors.initials: N
authors.lastname: Uesugi
authors.forename: Kohsuke
authors.initials: K
authors.lastname: Masutani
authors.forename: Ritsuko
authors.initials: R
authors.lastname: Katafuchi
authors.forename: Hideki
authors.initials: H
authors.lastname: Hirakata
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Iida
mesh_terms: D000368:Aged; D005260:Female; D015432:Glomerulonephritis, Membranoproliferative / Q000150:complications* / Q000188:drug therapy*; D005938:Glucocorticoids / Q000627:therapeutic use*; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D011239:Prednisolone / Q000627:therapeutic use*; D012074:Remission Induction
chemical_list: D005938:Glucocorticoids; D011239:Prednisolone