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用泼尼松龙和干扰素治疗丙型肝炎病毒相关冷球蛋白血症伴膜增生性肾小球肾炎:一例报告

Hepatitis C virus-associated cryoglobulinemia with membrano-proliferative glomerulonephritis treated with prednisolone and interferon: A case report.

作者信息

Guo Qiao-Yan, Wu Man, Wang Yang-Wei, Sun Guang-Dong

机构信息

Department of Nephrology, The Second Hospital of Jilin University, Changchun, Jilin 130041, P.R. China.

出版信息

Exp Ther Med. 2017 Aug;14(2):1395-1398. doi: 10.3892/etm.2017.4671. Epub 2017 Jun 26.

Abstract

Hepatitis C virus (HCV) is a major cause of liver-associated morbidity and has an increasing prevalence worldwide. Hepatitis C virus infection may lead to chronic hepatitis, cirrhosis and liver failure. However, it is also associated with a wide range of extra-hepatic complications, such as cryoglobulinemia, an immune complex disease associated with cryoglobulin leading to multiple organ damage and, while the major symptom is vasculitis. The present study reported on a-58-year-old woman who was diagnosed with HCV-associated cryoglobulinemia with skin, kidney and blood system damage and biopsy-proven cryoglobulinemia membrano-proliferative glomerulonephritis. HCV RNA clearance occurred within a few weeks of interferon treatment and the patient was then treated by prednisolone and sustained interferon. While the therapeutic effect was obvious at first, the disease reappeared in combination with refractory infection and multiple organ failure, and the patient finally died. HCV-associated cryoglobulinemia is uncommon in developing countries such as China, while treatment guidelines remain to be established, particularly if complex complications are present.

摘要

丙型肝炎病毒(HCV)是肝脏相关发病的主要原因,在全球范围内的患病率呈上升趋势。丙型肝炎病毒感染可能导致慢性肝炎、肝硬化和肝衰竭。然而,它还与多种肝外并发症相关,如冷球蛋白血症,这是一种与冷球蛋白相关的免疫复合物疾病,可导致多器官损害,其主要症状为血管炎。本研究报告了一名58岁女性,她被诊断为伴有皮肤、肾脏和血液系统损害的HCV相关性冷球蛋白血症,且活检证实为冷球蛋白血症性膜增生性肾小球肾炎。干扰素治疗几周内HCV RNA清除,随后患者接受泼尼松龙和长效干扰素治疗。虽然起初治疗效果明显,但疾病复发并伴有难治性感染和多器官衰竭,患者最终死亡。HCV相关性冷球蛋白血症在像中国这样的发展中国家并不常见,同时治疗指南仍有待建立,尤其是在存在复杂并发症的情况下。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/abee/5525644/435a3a716f6d/etm-14-02-1395-g00.jpg

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