Histopathologic Correlation between Chronic Hepatitis B and Nephropathy.
- Author:
Hyun Woong LEE
1
;
Chae Yoon CHON
;
Young Nyun PARK
;
Kwan Sik LEE
;
Sang Hoon AHN
;
Chang Hwan CHOI
;
Young Soo PARK
;
June Won CHEONG
;
Joo Hyuk SOHN
;
Jae Youn CHEONG
;
Kun Hoon SONG
;
Kwang hyub HAN
;
Young Myoung MOON
Author Information
1. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. cychon@yumc.yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
Heaptitis/Viral/Chronic Hepatitis B;
Liver biopsy;
Nephropathy;
Renal biopsy
- MeSH:
Biopsy;
Capillaries;
Classification;
Fibrosis;
Fluorescent Antibody Technique;
Glomerulonephritis, IGA;
Glomerulonephritis, Membranoproliferative;
Glomerulonephritis, Membranous;
Hematuria;
Hepatitis;
Hepatitis B e Antigens;
Hepatitis B Surface Antigens;
Hepatitis B, Chronic*;
Hepatitis, Chronic*;
Humans;
Immunoglobulin G;
Kidney;
Liver;
Liver Diseases;
Microscopy;
Nephrosis, Lipoid;
Proteinuria;
Reference Values;
Research Personnel
- From:The Korean Journal of Hepatology
2001;7(4):413-422
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUNDS/AIMS: The relationship between HBV infection and nephropathy has been reported with some differences according to the investigators and regions studied. Liver biopsies were not performed in most of the reports. In this study both liver and kidney biopsies were performed. The histologic correlation was analyzed between chronic B viral hepatitis and nephropathy. METHODS: From January 1985 to June 2000, both liver and kidney biopsies were performed on 26 patients who had chronic hepatitis B, proteinuria, and hematuria. Also, a new histopathologic classification of chronic hepatitis was applied in the assessment of liver disease. RESULT: Light microscopy of kidneys showed IgA nephropathy in 7 cases (27%); minimal change nephrotic syndrome (MCNS) in 1 case (3.8%); and membranous glomerulonephritis (MGN) in 9 cases (34.6%), membranoproliferative glomerulonephritis (MPGN) in 9 cases (34.6%). Among the cases with a higher hepatitis activity index and fibrosis score, the frequency of MGN and MPGN was higher. The hepatitis activity index of cases with MGN was significantly higher than IgA nephropathy and MPGN (p=0.011, p=0.039). The fibrosis score of cases with MGN and MPGN was significantly higher than IgA nephropathy (p=0.011, p=0.003). The positivity of HBeAg was highest in cases with MGN. Serum C3 level was low in all cases but the serum C4 level was within normal range. Immunofluorescence studies showed granular deposition of IgG and C3 in the capillary loops in MGN. CONCLUSION: The frequency of MGN and MPGN was higher when the liver disease was more severe. It was suggested that HBeAg, IgG and C3 might contribute to the pathogenesis of MGN in HBsAg positve patients.
