Clinicopathologic Features of Glomerular Lesions Associated with Hepatitis C Virus Infection in Japan

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概要

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• 要事前照会Background We determined the incidence of hepatitis C virus (HCV)-related glomerulonephritis in Japan and the glomerular localization of HCV-related antigens in this disorder. Methods We analyzed urinalysis findings in 100 consecutive Japanese patients with HCV chronic liver disease from 1993 to 1994. Immunohistochemical analysis using monoclonal or polyclonal antibodies to HCV-core antigen and polyclonal antibodies to HCV-envelope antigen was done on kidney specimens from 11 of 29 patients with antibody to HCV (anti-HCV-Ab). Results Eight of 100 patients had proteinuria, but only 2 cases (2%) were related to HCV nephropathy. Pathohistologic analysis showed 10 patients to have hepatic glomerulosclerosis, and 9 patients had mesangial proliferative glomerulonephritis involving primary immunoglobulin A nephropathy. Membranoproliferative glomerulonephritis was seen in 4 biopsy specimens that showed subendothelial electron-dense deposits and annular structures with characteristic cryogloblin. HCV core antigen was detected along the capillary walls with the same pattern as that of immunoglobulin G deposition and electron-dense deposits in 5 of 6 specimens from patients with both anti-HCV-Ab and HCV ribonucleic acid positive in the sera, but could not be detected in any of 3 specimens, from patients with anti-HCV-Ab but no HCV ribonucleic acid. Envelope antigen was not detected in the glomeruli of any specimens. Conclusions Glomerular lesions associated with HCV infection were characterized by deposition of immune complexes containing HCV core antigen and immunoglobulin G, and by the subendothelial deposition of cryoglobulin. These HCV-related glomerular diseases are rare in Japan (2% incidence), and these lesions should be distinguished from hepatic glomerulosclerosis related to advanced liver disease and other primary glomerular diseases.

• 日本腎臓学会 = Japanese Society of Nephrologyの論文

著者

• Yokoyama Hitoshi

  金沢大学 医学系研究科恒常性制御学

• Wada Takashi

  金沢大学 医学部血液浄化療法部

• Furuichi K

  金沢大学 医学系研究科恒常性制御学

• Furuichi Kengo

  Kanazawa Univ. Hospital Kanazawa Jpn

• Furuichi Kengo

  First Department Of Internal Medicine School Of Medicine Kanazawa University

• Yokoyama H

  Division Of Blood Purification Department Of Gastroenterology And Nephrology Graduate School Of Medi

• Wada Takashi

  Kanazawa Univ. Graduate School Of Medical Sci. Kanazawa Jpn

• YOKOYAMA Hitoshi

  Division of Blood Purification, Kanazawa University Hospital

• Ohta Satoshi

  First Department Of Internal Medicine Mie University School Of Medicine

• KOBAYASHI Ken-ichi

  First Department of Internal Medicine, Kanazawa University School of Medicine

• Wada T

  Division Of Blood Purification Department Of Gastroenterology And Nephrology Graduate School Of Medi

• WADA Takashi

  First Department of Internal Medicine, Kanazawa University School of Medicine

• SEGAWA Chikako

  First Department of Internal Medicine, Division of Blood Purification, Kanazawa University School of

• TAKASAWA Kazuya

  Department of Internal Medicine, Kanazawa National Hospital

• HISADA Yukimasa

  First Department of Internal Medicine School of Medicine, Kanazawa University

• TAKASAWA Kazuya

  Division of Bolld Purification, School of Medicine, Kanazawa University

• Kobayashi Ken-ichi

  Department Of Gastroenterology And Nephrology Kanazawa University Graduate School Of Medicine

• Kobayashi Ken-ichi

  First Department Of Internal Medicine School Of Medicine Kanazawa University

• Segawa Chikako

  First Department Of Internal Medicine Division Of Blood Purification Kanazawa University School Of M

• Ohta S

  Mitsubishi Heavy Ind. Ltd. Yokohama Jpn

• Wada Takashi

  Department Of Laboratory Medicine Kanazawa University Graduate School Of Medical Science

• Takasawa Kazuya

  Department Of Internal Medicine Kanazawa National Hospital

• Hisada Y

  Tanabe Seiyaku Co. Ltd. Osaka Jpn

• Wada T

  Department Of Laboratory Medicine Graduate School Of Medical Science Kanazawa University

• Kobayashi K

  Toyama Univ. Toyama

• Kobayashi Ken-ichi

  First Department Of Internal Medicine Kanazawa University School Of Medicine

• Kobayashi Kenichi

  First Department Of Internal Medicine School Of Medicine Kanazawa University

• Yokoyama Hitoshi

  Division of Blood Purification, Department of Gastroenterology and Nephrology, Graduate School of Medical Science, Kanazawa University

• Takasawa Kazuya

  Division of Blood Purification, Kanazawa University

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