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免疫介导的乙型肝炎病毒感染继发新月体性膜增生性肾小球肾炎:一种常见感染的罕见表现。

Immune mediated crescentic MPGN secondary to HBV infection: A rare presentation for a common infection.

作者信息

Mareddy Aswani Srinivas, Rangaswamy Dharshan, Vankalakunti Mahesha, Attur Ravindra Prabhu, Nagaraju Shankar Prasad, Koti Neeraja

机构信息

Department of Nephrology, Kasturba Medical College, Manipal University, Mangalore, India.

Department of Pathology and Lab Medicine, Manipal Hospitals, Bengaluru, India.

出版信息

Australas Med J. 2016 Jan 31;9(1):12-6. doi: 10.4066/AMJ.2015.2568. eCollection 2016.

Abstract

Hepatitis B virus (HBV) infection presenting as crescentic glomerulonephritis in the absence of cryoglobulinemia is an extremely rare phenomenon. We report a case of a 44-year-old male with HBV infection, who underwent kidney biopsy for rapidly progressive renal failure and nephrotic range proteinuria. Histopathological evaluation of the kidney biopsy was consistent with immune complex mediated crescentic membranoproliferative glomerulonephritis (MPGN). The patient achieved complete renal and virological remission with steroids, plasmapheresis and antiviral therapy. This case report summarises the importance of early initiation of immunosuppression and plasmapheresis under antiviral coverage for improved clinical outcomes.

摘要

在无冷球蛋白血症情况下表现为新月体性肾小球肾炎的乙型肝炎病毒(HBV)感染是一种极其罕见的现象。我们报告一例44岁男性HBV感染患者,该患者因快速进展性肾衰竭和肾病范围蛋白尿接受了肾活检。肾活检的组织病理学评估与免疫复合物介导的新月体性膜增生性肾小球肾炎(MPGN)一致。该患者通过类固醇、血浆置换和抗病毒治疗实现了完全的肾脏和病毒学缓解。本病例报告总结了在抗病毒治疗的同时早期开始免疫抑制和血浆置换以改善临床结局的重要性。

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Chronic viral hepatitis and chronic kidney disease.慢性病毒性肝炎与慢性肾脏病。
Postgrad Med J. 2010 Aug;86(1018):486-92. doi: 10.1136/pgmj.2009.092775.
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Hepatitis B: the virus and disease.乙型肝炎:病毒与疾病
Hepatology. 2009 May;49(5 Suppl):S13-21. doi: 10.1002/hep.22881.

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