Successful treatment of HCV-related cryoglobulinemic glomerulonephritis with double-filtration plasmapheresis and interferon combination therapy.
A 67-year-old, hepatitis C virus (HCV)-positive woman was admitted to our hospital because of proteinuria and leg edema. Laboratory examination showed decreased serum albumin and complement activity and positive cryoglobulin. The HCV RNA genotype was 1b with high viral load. Kidney biopsy showed membranoproliferative glomerulonephritis (MPGN) with capillary deposition of C3, IgM, and IgG, indicating HCV-associated glomerulonephritis. In addition to interferon (IFN) therapy, double-filtration plasmapheresis (DFPP) was performed to reduce HCV RNA blood levels in the early stage of IFN therapy. This treatment greatly reduced the viral load and induced clinical remission of MPGN, suggesting that DFPP plus IFN combination therapy may represent a potentially effective modality for refractory-type HCV-associated glomerulonephritis.
Namba
Tomoko
T
Osaka Rosai Hospital, Sakai, Japan.
Shiba
Rie
R
Yamamoto
Takeshi
T
Hirai
Yasuhiro
Y
Moriwaki
Takuma
T
Matsuda
Jun
J
Kadoya
Hiroyuki
H
Takeji
Masanobu
M
Yamada
Yukinori
Y
Yoshihara
Harumasa
H
Yamauchi
Atsushi
A
D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D001706:Biopsy; D003131:Combined Modality Therapy; D003449:Cryoglobulinemia / Q000188:drug therapy / Q000628:therapy* / Q000821:virology; D004359:Drug Therapy, Combination; D004487:Edema / Q000628:therapy / Q000821:virology; D005260:Female; D005838:Genotype; D015432:Glomerulonephritis, Membranoproliferative / Q000188:drug therapy / Q000628:therapy* / Q000821:virology; D016174:Hepacivirus / Q000235:genetics; D006526:Hepatitis C / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D006801:Humans; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use*; D007668:Kidney / Q000473:pathology / Q000821:virology; D010956:Plasmapheresis; D011092:Polyethylene Glycols / Q000627:therapeutic use*; D011507:Proteinuria / Q000628:therapy / Q000821:virology; D012367:RNA, Viral / Q000097:blood; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load
D000998:Antiviral Agents; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D012367:RNA, Viral; D011994:Recombinant Proteins; D011092:Polyethylene Glycols; D012254:Ribavirin; C417083:peginterferon alfa-2b
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