Hepatitis B virus associated focal and segmental glomerular sclerosis: report of two cases and review of literature.
The hepatitis B virus (HBV) is estimated to have infected about 350 million people worldwide, making it one of the most common human pathogens. Renal involvement is among its most common extra hepatic manifestations and usually manifests in the form of immune complex mediated glomerulopathy, such as membranous glomerulonephritis (MGN), membranoproliferative glomerulonephritis (MPGN), mesangioproliferative glomerulonephritis and immunoglobulin A (IgA) nephropathy. Occurrence of focal and segmental glomerular sclerosis (FSGS) with HBV infection is rare and only five cases have been reported earlier. We report two cases of hepatitis B associated FSGS. In both the cases, HBsAg was demonstrated in the renal tissue and both the cases showed response to treatment with lamivudine, thus indicating a possible causal association between the viral infection and occurrence of nephrotic syndrome.
Khaira
Ambar
A
Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India.
Upadhyay
Bala Krishna
BK
Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India.
Sharma
Alok
A
Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India. dr_aalok@yahoo.com.
Das
Prasenjit
P
Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
Mahajan
Sandeep
S
Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India.
Makhariya
Govind
G
Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India.
Dinda
Amit K
AK
Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.
Agarwal
Sanjay K
SK
Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India.
Tiwari
Suresh C
SC
Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India.
D000293:Adolescent; D001706:Biopsy; D004279:DNA, Viral / Q000097:blood; D005923:Glomerulosclerosis, Focal Segmental / Q000188:drug therapy / Q000821:virology*; D006509:Hepatitis B / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D006511:Hepatitis B Antigens / Q000032:analysis*; D006512:Hepatitis B Core Antigens / Q000032:analysis; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology*; D006801:Humans; D007150:Immunohistochemistry; D007668:Kidney / Q000821:virology*; D019259:Lamivudine / Q000627:therapeutic use; D008297:Male; D009404:Nephrotic Syndrome / Q000188:drug therapy / Q000821:virology*; D011507:Proteinuria / Q000821:virology; D016896:Treatment Outcome
D004279:DNA, Viral; D006511:Hepatitis B Antigens; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens; D019259:Lamivudine