Mareddy Aswani Srinivas, Rangaswamy Dharshan, Vankalakunti Mahesha, Attur Ravindra Prabhu, Nagaraju Shankar Prasad, Koti Neeraja
Department of Nephrology, Kasturba Medical College, Manipal University, Mangalore, India.
Department of Pathology and Lab Medicine, Manipal Hospitals, Bengaluru, India.
Australas Med J. 2016 Jan 31;9(1):12-6. doi: 10.4066/AMJ.2015.2568. eCollection 2016.
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.
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。