Membranous nephropathy associated with chronic hepatitis B occurring in a short period after acute hepatitis B virus infection.
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.
Nakahara
Kazunari
K
Department of Internal Medicine, Division of Gastroenterology and Hepatology, St. Marianna University, School of Medicine, Kawasaki.
Takahashi
Hideaki
H
Okuse
Chiaki
C
Shigefuku
Ryuta
R
Yamada
Norie
N
Murao
Mei
M
Matsunaga
Kotaro
K
Koike
Junki
J
Yotsuyanagi
Hiroshi
H
Suzuki
Michihiro
M
Kimura
Kenjiro
K
Itoh
Fumio
F
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
D000998:Antiviral Agents; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D016898:Interferon-alpha