Sakallioglu O, Gok F, Kalman S, Kurekci A E, Gunhan O, Gokcay E
Pediatric Nephrology Unit, Gulhane Military Medical Academy, Etlik-Ankara - Turkey.
J Nephrol. 2005 Jul-Aug;18(4):433-5.
After the initial report of membranous glomerulopathy due to hepatitis B virus infection by Combes et al, other glomerular diseases - but rarely focal segmental glomerulosclerosis (FSGS) association with HBV infection - have been reported. Herein we present an 8-year-old boy with chronic HBV infection complicated FSGS. The patient was initially regarded as idiopathic FSGS and started on an immunosuppressive schedule. The elevation of liver transaminases in the course of the therapy revealed the immunotolerated perinatal HBV infection. It was considered that immunosuppressive agents have induced viral replication. The treatment was changed to lamivudine alone. The nephrotic syndrome has already been improved with the seroconversion of anti-HBeAg and reduced liver functional tests by the tenth month of the treatment. This case is peculiar for the seldom association of FSGS with chronic HBV infection and treatment modality particularly for the countries where this viral infection is endemic.
在Combes等人首次报道乙型肝炎病毒感染导致膜性肾小球病之后，其他肾小球疾病——但与HBV感染相关的局灶节段性肾小球硬化（FSGS）很少见——也有报道。在此，我们报告一名8岁慢性HBV感染并发FSGS的男孩。该患者最初被视为特发性FSGS，并开始接受免疫抑制治疗方案。治疗过程中肝转氨酶升高揭示了围产期免疫耐受的HBV感染。据认为免疫抑制剂诱导了病毒复制。治疗改为单用拉米夫定。到治疗第十个月时，随着抗HBeAg血清学转换和肝功能检查指标降低，肾病综合征已得到改善。该病例因FSGS与慢性HBV感染的罕见关联以及治疗方式而显得特殊，特别是在这种病毒感染流行的国家。
