title: Cryoglobulinemic membranoproliferative glomerulonephritis: beyond conventional therapy.
abstract: Membranoproliferative glomerulonephritis associated with Type II cryoglobulinemia is the predominant type of HCV-related glomerulonephritis. Immunosuppressive and anti-viral therapy is alternately used to treat it, but the results are not always satisfactory or lasting. In this paper we report 3 cases of cryoglobulinemic membranoproliferative glomerulonephritis, treated with different and personalized therapeutic approaches by using conventional therapy and new drugs such as mycophenolate mofetil and rituximab. Our case series report emphasizes the importance of choosing the treatment for each patient, taking into account many factors: age, severity of liver and renal involvement, extra-renal manifestations, any previous treatment, contraindications or adverse events and last but not least the balance between immunosuppression and virus activity.
authors.affiliation: Renal, Dialysis and Transplant Unit, Department of Emergency and Organ Transplant, University of Bari, Bari, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Colucci
authors.forename: C
authors.initials: C
authors.lastname: Manno
authors.forename: G
authors.initials: G
authors.lastname: Grandaliano
authors.forename: F P
authors.initials: FP
authors.lastname: Schena
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000368:Aged; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D058846:Antibodies, Monoclonal, Murine-Derived / Q000627:therapeutic use; D000998:Antiviral Agents / Q000627:therapeutic use; D001713:Biphenyl Compounds / Q000627:therapeutic use; D003449:Cryoglobulinemia / Q000188:drug therapy*; D005260:Female; D015432:Glomerulonephritis, Membranoproliferative / Q000188:drug therapy*; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D000077190:Interferon alpha-2; D016898:Interferon-alpha / Q000627:therapeutic use; D000077405:Irbesartan; D008297:Male; D008875:Middle Aged; D009173:Mycophenolic Acid / Q000031:analogs & derivatives / Q000627:therapeutic use; D011092:Polyethylene Glycols / Q000627:therapeutic use; D011994:Recombinant Proteins; D012254:Ribavirin / Q000627:therapeutic use; D000069283:Rituximab; D013777:Tetrazoles / Q000627:therapeutic use
chemical_list: D000305:Adrenal Cortex Hormones; D047228:Angiotensin II Type 1 Receptor Blockers; D000894:Anti-Inflammatory Agents, Non-Steroidal; D058846:Antibodies, Monoclonal, Murine-Derived; D000998:Antiviral Agents; D001713:Biphenyl Compounds; D007155:Immunologic Factors; D000077190:Interferon alpha-2; D016898:Interferon-alpha; D011994:Recombinant Proteins; D013777:Tetrazoles; D011092:Polyethylene Glycols; D012254:Ribavirin; D000069283:Rituximab; C417083:peginterferon alfa-2b; D009173:Mycophenolic Acid; D000077405:Irbesartan