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Successful steroid treatment in a patient with membranoproliferative glomerulonephritis associated with hepatitis C virus

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Abstract

Thirteen years ago, a 65-year-old woman was diagnosed to have chronic active hepatitis with hepatitis C virus. After starting interferonα administration, she noticed edema and hypoalbuminemia. Renal biopsy revealed mesangial proliferation with focal endocapillary proliferation, and double contour of the glomerular basement membrane due to mesangial interposition. Interferonα was discontinued, and proteinuria and edema gradually decreased. She was re-admitted due to a relapse of proteinuria 8 years later. Biopsy revealed moderate mesangial and endcapillary proliferation presenting a lobular pattern, in addition to the presence of hyaline thrombi. Granular staining of immunoglobulin M and of C3 in capillary walls were detected. Since cryoglobulinemia was positive, a final diagnosis of cryoglobulinemic membranoproliferative glomerulonephritis was made. Prednisolone was started with an initial dose of 20 mg/day. Proteinuria and hypoalbuminemia improved, and prednisolone was tapered to 5 mg/day 9 months after the 2nd renal biopsy. The hepatitis C virus-RNA titer fluctuated.

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Authors and Affiliations

  1. The Division of Nephrology and Clinical Research Institute, National Kyushu Medical Center, Fukuoka, Japan

    Toru Sanai, Izumi Watanabe, Tadashi Hirano & Masaru Nakayama

  2. The Division of Hepatology, National Kyushu Medical Center, Fukuoka, Japan

    Hironori Sakai

  3. The Department of Pathology, National Kyushu Medical Center, Fukuoka, Japan

    Noriko Uesugi

  4. The Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan

    Kohsuke Masutani, Hideki Hirakata & Mitsuo Iida

  5. The Kidney Center, Fukuoka Red Cross Hospital, Fukuoka, Japan

    Ritsuko Katafuchi

  6. The Department of Cardiovascular and Renal Medicine, Saga University Faculty of Medicine, 5-1-1 Nabeshima, 849-8501, Saga, Japan

    Toru Sanai

Authors
  1. Toru Sanai
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  2. Izumi Watanabe
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  3. Tadashi Hirano
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  4. Masaru Nakayama
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  5. Hironori Sakai
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  6. Noriko Uesugi
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  7. Kohsuke Masutani
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  8. Ritsuko Katafuchi
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  9. Hideki Hirakata
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  10. Mitsuo Iida
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Correspondence to Toru Sanai.

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Sanai, T., Watanabe, I., Hirano, T. et al. Successful steroid treatment in a patient with membranoproliferative glomerulonephritis associated with hepatitis C virus. Int Urol Nephrol 41, 179–183 (2009). https://doi.org/10.1007/s11255-007-9322-7

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  • DOI: https://doi.org/10.1007/s11255-007-9322-7

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