title: Clinicopathological features of cryoglobulinemic glomerulonephritis associated with HBV infection: a retrospective analysis of 8 cases in China.
abstract: OBJECTIVE
  We retrospectively analyzed clinicopathologic features of 8 cases of hepatitis B virus-associated glomerulonephritis with hyaline thrombi, to confirm the diagnosis of cryoglobulinemic glomerulonephritis (CRYGN) associated with HBV infection.
  
  
  METHODS
  Retrospective analysis was carried out with demographic information, clinical manifestations, laboratory parameters, pathological and prognostic features.
  
  
  RESULTS
  The median age of 8 patients was 30.5 years (range, 21-75 years), including 6 males and 2 femles (M:F = 3:1). One patient had Raynaud's syndrome. Cryoglobulin testing was performed in 4 cases of our series, and 3 cases had elevated cryocrit (>256). Serum C4 decreased in all detected cases. Histopathologically, all cases showed hyaline thrombi occluded in capillary lumina; Co-deposit of IgG, IgM, IgA, Fib, C3d, C4d, C1q, HBsAg and HBcAb were identified in hyaline deposit/hyaline thrombi with polyclonal Igκ and Igλ staining. Ultrastructural examination confirmed the hyaline thrombi to be huge electron-dense bodies, which were a homogeneous texture.
  
  
  CONCLUSIONS
  The results suggest that 8 cases in the series are CRYGN associated with HBV infection. The incidence of CRYGN associated HBV was extremely low. Our series suggested that prognosis of CRYGN associated HBV was better in patients with mild symptoms, but it was poor in elder patients with severe vasculitis.
authors.affiliation: Department of Pathology, Fujian Provincial Hospital, Fujian Provincial Clinical College of Fujian Medical University Fuzhou, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Wang
authors.affiliation: Department of Pathology, The First Affiliated Hospital of Sun Yat-sen University Guangzhou, China.
authors.forename: Zi-Yin
authors.initials: ZY
authors.lastname: Ye
authors.affiliation: Department of Pathology, Dongfang Hospital, Fujian Medical University Fuzhou, China.
authors.forename: De-Hua
authors.initials: DH
authors.lastname: Zeng
authors.affiliation: Department of Pathology, Dongfang Hospital, Fujian Medical University Fuzhou, China.
authors.forename: Fei-Lai
authors.initials: FL
authors.lastname: Xie
authors.affiliation: Department of Pathology, Dongfang Hospital, Fujian Medical University Fuzhou, China.
authors.forename: Li-Juan
authors.initials: LJ
authors.lastname: Qu
authors.affiliation: Department of Pathology, Dongfang Hospital, Fujian Medical University Fuzhou, China.
authors.forename: Zhi-Yong
authors.initials: ZY
authors.lastname: Zheng
mesh_terms: D000328:Adult; D000368:Aged; D000818:Animals; D002681:China; D003449:Cryoglobulinemia / Q000209:etiology*; D005921:Glomerulonephritis / Q000209:etiology*; D006509:Hepatitis B / Q000150:complications*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D046529:Microscopy, Electron, Transmission; D008875:Middle Aged; D011817:Rabbits; D012189:Retrospective Studies; D055815:Young Adult
keywords: Hyaline thrombi; cryoglobulinemia; glomerulonephritis; hepatitis B virus