Poitrine A, Delfraissy J F, Brunaud M D, Brivet F, Pillot J, Dormont J, Chaput J C
Gastroenterol Clin Biol. 1983 Jun-Jul;7(6-7):610-7.
The association of glomerulonephritis and persistent HBs antigenemia is reported in 4 adults with nephrotic syndrome: 2 cases of membranous glomerulonephritis associated with chronic persistent hepatitis and 2 cases of membrano-proliferative glomerulonephritis associated with active cirrhosis. In 3 patients, all positive for HBsAg, anti-HBc and HBeAg by radioimmunoassay, indirect immunofluorescent study was performed on kidney and liver biopsies. Glomerular deposit of HBcAg was detected in two cases. HBsAg and HBcAg were not found in the liver. The pathogenesis of such glomerulonephritis remains uncertain and the role of HBs antigen-antibody circulating immune complexes is not clearly proved. Two patients were treated with vidarabine intravenously. Vidarabine produced a transitory decrease of HBsAg concentration in 2 cases and a transitory loss of DNA-polymerase activity associated with a decrease of HBeAg concentration in one case. Neither seroconversion nor improvement of the glomerular disease were ascertained.
据报道，4例患有肾病综合征的成人出现肾小球肾炎与持续性乙肝表面抗原血症相关：2例膜性肾小球肾炎与慢性持续性肝炎相关，2例膜增生性肾小球肾炎与活动性肝硬化相关。3例患者经放射免疫测定乙肝表面抗原、乙肝核心抗体和e抗原均呈阳性，对其肾和肝活检组织进行了间接免疫荧光研究。在2例中检测到肾小球内有乙肝核心抗原沉积。肝内未发现乙肝表面抗原和乙肝核心抗原。此类肾小球肾炎的发病机制仍不确定，乙肝抗原-抗体循环免疫复合物的作用也未得到明确证实。2例患者接受了静脉注射阿糖腺苷治疗。阿糖腺苷使2例患者的乙肝表面抗原浓度暂时下降，1例患者出现DNA聚合酶活性暂时丧失并伴有e抗原浓度下降。未确定是否发生血清转化或肾小球疾病有所改善。
