Successful steroid treatment in a patient with membranoproliferative glomerulonephritis associated with hepatitis C virus.
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.
Sanai
Toru
T
Division of Nephrology, National Kyushu Medical Center, Fukuoka, Japan. sunny@cc.saga-u.ac.jp
Watanabe
Izumi
I
Hirano
Tadashi
T
Nakayama
Masaru
M
Sakai
Hironori
H
Uesugi
Noriko
N
Masutani
Kohsuke
K
Katafuchi
Ritsuko
R
Hirakata
Hideki
H
Iida
Mitsuo
M
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
D005938:Glucocorticoids; D011239:Prednisolone