Takishita Y, Ishikawa S, Okada K
Department of Internal Medicine, Tokushima Prefectural Central Hospital, Japan.
Nihon Jinzo Gakkai Shi. 1994 Oct;36(10):1203-8.
Although the occasional occurrence of glomerulonephritis associated with hepatitis C virus (HCV) infection has been reported recently in the literature, the type described has been mainly membranoproliferative glomerulonephritis (MPGN); membranous glomerulonephritis (MGN) is very rare. In this paper, two cases of MGN associated with HCV infection are reported. Case 1 was a 56-year-old male who had positive HCV Ab and HCV RNA. The diagnosis of chronic active hepatitis was verified by liver biopsy. Laboratory data showed proteinuria (5g per day), hematuria and hypocomplementemia by hemolytic assay. Renal biopsy led to the diagnosis of MGN in stage II. The patient was treated with interferon alpha for 6 months, resulting in improvement of hypocomplementemia, transient reduction of GOT and GPT during the course of treatment. The GOT and GPT were aggravated again after the completion of therapy. No improvement was seen in proteinuria and hematuria, and HCV Ab remained positive. Case 2 was a 69-year-old male who had positive HCV Ab and HCV RNA, and had normal liver function. Subsequently, his GOT value was slightly elevated. Proteinuria (2g per day) was demonstrated. The diagnosis of MGN in stage II was made on the basis of renal biopsy. The clinical characteristics of these two cases suggest that MGN is a type of glomerulonephritis associated with HCV infection.
尽管近期文献报道了偶发的丙型肝炎病毒（HCV）感染相关的肾小球肾炎，但所描述的类型主要是膜增生性肾小球肾炎（MPGN）；膜性肾小球肾炎（MGN）非常罕见。本文报道了2例与HCV感染相关的MGN病例。病例1是一名56岁男性，HCV抗体和HCV RNA均为阳性。肝活检证实为慢性活动性肝炎。实验室检查数据显示有蛋白尿（每日5g）、血尿，溶血试验提示低补体血症。肾活检诊断为Ⅱ期MGN。患者接受了6个月的α干扰素治疗，治疗过程中低补体血症有所改善，谷草转氨酶（GOT）和谷丙转氨酶（GPT）短暂下降。治疗结束后GOT和GPT再次升高。蛋白尿和血尿未见改善，HCV抗体仍为阳性。病例2是一名69岁男性，HCV抗体和HCV RNA阳性，肝功能正常。随后，其GOT值略有升高。出现蛋白尿（每日2g）。根据肾活检诊断为Ⅱ期MGN。这2例病例的临床特征提示MGN是一种与HCV感染相关的肾小球肾炎类型。
