Urinary Abnormalities in Chronic Hepatitis C – A Follow-Up Study

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Abstract

Extrahepatic manifestations of hepatitis C virus (HCV) infection have been reported, in particular essential mixed cryoglobulinemia, lichen planus and thyroid disorders [1]. In addition, evidence of HCV infection has been found in patients with glomerulonephritis, but the exact incidence of urinary abnormalities in patients with this infection is unknown [2]. The present study was undertaken to investigate urinary abnormalities in patients with chronic hepatitis C.

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Membranoproliferative glomerulonephritis associated with hepatitis C virus infection.

David Gretch, H Yamabe, L Corey … (1993)

Hepatitis C virus (HCV) infection causes both acute and chronic liver disease and is also associated with mixed cryoglobulinemia. Whether HCV is also associated with renal disease, as is the hepatitis B virus, is not known. We describe the clinical, pathologic, virologic, and immunologic features of eight patients with HCV infection who were referred to nephrologists for glomerulonephritis. Four patients were treated with interferon alfa. All eight patients had proteinuria, and seven had decreased renal function. Renal biopsy in all patients revealed membranoproliferative glomerulonephritis, characterized by the deposition of IgG, IgM, and C3 in glomeruli. Electron microscopy of the biopsy specimens showed cryoglobulin-like structures in three of four patients. All eight patients had HCV RNA detected in their serum, elevated serum aminotransferase concentrations, and hypocomplementemia, and the majority had cryoglobulins and circulating immune complexes in their serum. Cryoprecipitates from the three patients who were tested contained HCV RNA and IgG anti-HCV antibodies to the nucleocapsid core antigen (HCVc or c22-3). IgM rheumatoid factors, present in all patients, bound anti-HCV IgG in all six patients tested. Four patients received interferon alfa for 2 to 12 months; all had evidence of decreased HCV replication and improvement of their renal and liver disease. Chronic HCV infection is associated with cryoglobulinemia and membranoproliferative glomerulonephritis. The pathogenesis is unknown, but may relate to deposition within glomeruli of immune complexes containing HCV, anti-HCV IgG, and IgM rheumatoid factors.

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Journal ID (publisher-id): NEF

Journal ID (nlm-ta): Nephron

Journal ID (doi): 10.1159/issn.1660-8151

Title: Nephron

Publisher: S. Karger AG

ISSN (Print): 1660-8151

ISSN (Electronic): 2235-3186

Publication date Subscription-year: 1998

Publication date (Print): February 1998

Publication date (Electronic): 26 January 1998

Volume: 78

Issue: 2

Page: 237

Affiliations

Divisions of ^a Nephrology and ^b Gastroenterology, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil

Article

Publisher ID: 44924 Other ID: Nephron 1998;78:237

DOI: 10.1159/000044924

PubMed ID: 9496751

SO-VID: 129b0e42-5c43-4e33-8ef2-0ee96dbdc7eb

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Urinary Abnormalities in Chronic Hepatitis C – A Follow-Up Study

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Karger: Nephrology

Most cited references 1

Membranoproliferative glomerulonephritis associated with hepatitis C virus infection.

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