Cueto-Manzano A M, Poo J L, Gamboa-Domínguez A, Quintanilla-Martínez L, Larriva-Sahd J, Correa-Rotter R
Departamentos de Nefrología, Instituto Nacional de la Nutrición, Salvader Zubirán, México, D.F.
Rev Invest Clin. 1995 May-Jun;47(3):189-96.
A possible association between hepatitis C virus infection (HCV) and membranoproliferative glomerulonephritis (MPGN) or membranous glomerulonephritis has recently been reported. The pathogenesis of this entity appears to be immunologically mediated. The purpose of this report is to describe the clinical, laboratory, and histopathological features of three patients with chronic HCV infection, without hepatitis B virus disease or autoimmune diseases, but with glomerular disease.
All three patients had chronic hepatopathy stigmata, ascitis, peripheral edema, and normal blood pressure values. Laboratory results showed mild liver function abnormalities and normal levels of blood nitrogenous waste products. Microscopic hematuria, hypoalbuminemia, and variable proteinuria without hypercholesterolemia were found in all cases. All three had positive rheumatoid factor. Only one patient had positive antinuclear antibodies and antimitochondrial antibodies at low levels, and another displayed low C3 and C4 serum levels. Renal histology in the three cases showed type I membranoproliferative glomerulonephritis and hepatic cirrhosis in the liver biopsy.
This report supports the association between chronic HCV infection and membranoproliferative glomerulonephritis. However, further studies are needed to establish more firmly the association as well as the mechanisms of pathogenesis and causality between them.
最近有报道称丙型肝炎病毒感染（HCV）与膜增生性肾小球肾炎（MPGN）或膜性肾小球肾炎之间可能存在关联。该病症的发病机制似乎是免疫介导的。本报告旨在描述三名慢性HCV感染患者的临床、实验室和组织病理学特征，这些患者无乙型肝炎病毒疾病或自身免疫性疾病，但患有肾小球疾病。
所有三名患者均有慢性肝病体征、腹水、外周水肿，血压值正常。实验室结果显示肝功能轻度异常，血含氮废物水平正常。所有病例均发现镜下血尿、低白蛋白血症和无高胆固醇血症的可变蛋白尿。所有三名患者类风湿因子均为阳性。只有一名患者抗核抗体和抗线粒体抗体呈低水平阳性，另一名患者血清C3和C4水平较低。三例患者的肾脏组织学显示为I型膜增生性肾小球肾炎，肝脏活检显示为肝硬化。
本报告支持慢性HCV感染与膜增生性肾小球肾炎之间的关联。然而，需要进一步研究以更确切地确定它们之间的关联以及发病机制和因果关系。
