title: Membranous nephropathy associated with chronic hepatitis B occurring in a short period after acute hepatitis B virus infection.
abstract: We herein present a case of membranous nephropathy associated with chronic hepatitis B following acute hepatitis B virus (HBV) infection. A 22-year-old man was admitted to our hospital for evaluation of proteinuria, pitting edema on both legs, and increased body weight in December 2002. At the age of 18, he had suffered from acute hepatitis A and syphilis, and was found to be negative for hepatitis B surface antigen (HBsAg). Furthermore, he suffered from acute hepatitis B (AH-B) at the age of 21; he was found to be positive for HBsAg and anti-IgM antibody to core antigen (IgM HBcAb). However, he discontinued outpatient treatment before confirmation of HBsAg clearance or the appearance of antibody to HBsAg (HBsAb). At the present admission, HBsAg, antibody to hepatitis B e antigen (HBeAg), and HBcAb were positive, while IgM HBcAb was negative. His genotype of HBV was type A (HBV/A). Histopathological findings of the renal biopsy specimen confirmed glomerulonephritis and glomerular deposition of HBsAg. Thus, he was diagnosed as having nephrotic syndrome caused by membranous nephropathy (MN) associated with chronic hepatitis B (CH-B) following AH-B. Although interferon-alpha (IFN-alpha) administration was started for the treatment and temporary improvement of proteinuria was observed, remission of MN was not achieved.
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology and Hepatology, St. Marianna University, School of Medicine, Kawasaki.
authors.forename: Kazunari
authors.initials: K
authors.lastname: Nakahara
authors.forename: Hideaki
authors.initials: H
authors.lastname: Takahashi
authors.forename: Chiaki
authors.initials: C
authors.lastname: Okuse
authors.forename: Ryuta
authors.initials: R
authors.lastname: Shigefuku
authors.forename: Norie
authors.initials: N
authors.lastname: Yamada
authors.forename: Mei
authors.initials: M
authors.lastname: Murao
authors.forename: Kotaro
authors.initials: K
authors.lastname: Matsunaga
authors.forename: Junki
authors.initials: J
authors.lastname: Koike
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yotsuyanagi
authors.forename: Michihiro
authors.initials: M
authors.lastname: Suzuki
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kimura
authors.forename: Fumio
authors.initials: F
authors.lastname: Itoh
mesh_terms: D000208:Acute Disease; D000998:Antiviral Agents / Q000627:therapeutic use; D001706:Biopsy; D015433:Glomerulonephritis, Membranous / Q000175:diagnosis* / Q000209:etiology* / Q000276:immunology; D006509:Hepatitis B / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006513:Hepatitis B e Antigens / Q000097:blood; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D006801:Humans; D016898:Interferon-alpha / Q000627:therapeutic use; D007668:Kidney / Q000473:pathology; D008297:Male; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D016898:Interferon-alpha