Pascual M, Thadhani R, Chung R T, Williams W W, Meehan S, Tolkoff-Rubin N, Colvin R, Cosimi A B
Transplantation Unit, Massachusetts General Hospital, Boston 02114, USA.
Transplantation. 1997 Oct 15;64(7):1073-6. doi: 10.1097/00007890-199710150-00022.
In recent years, hepatitis C virus infection has been reported to be typically associated with membranoproliferative glomerulonephritis and less frequently with membranous nephropathy. Treatment of hepatitis C with interferon-alpha can reduce viremia and improve renal disease. After liver transplantation for hepatitis C virus-associated liver failure, standard immunosuppressive protocols result in a significant increase in hepatitis C viremia. In this report we describe a patient with end-stage liver disease and biopsy-proven hepatitis C-associated glomerulonephritis who underwent liver transplantation. Within 1 month after transplantation, he developed a severe nephrotic syndrome that paralleled a marked increase in viremia. We discuss the possible pathogenic relationship between hepatitis C virus infection and the nephrotic syndrome that followed liver transplantation.
近年来,据报道丙型肝炎病毒感染通常与膜增生性肾小球肾炎相关,与膜性肾病的关联则较少见。用α干扰素治疗丙型肝炎可降低病毒血症并改善肾脏疾病。在因丙型肝炎病毒相关肝衰竭进行肝移植后,标准免疫抑制方案会导致丙型肝炎病毒血症显著增加。在本报告中,我们描述了一名患有终末期肝病且经活检证实为丙型肝炎相关肾小球肾炎的患者接受了肝移植。移植后1个月内,他出现了严重的肾病综合征,同时病毒血症显著增加。我们讨论了丙型肝炎病毒感染与肝移植后出现的肾病综合征之间可能的致病关系。