Membranous Nephropathy Associated with Chronic Hepatitis B Occurring in a Short Period After Acute Hepatitis B Virus Infection
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概要
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We herein present a case of membranous nephropathy associated with chronic hepatitis B following acute hepatitis B virus (HBV) infection. A 22-year-old man was admitted to our hospital for evaluation of proteinuria, pitting edema on both legs, and increased body weight in December 2002. At the age of 18, he had suffered from acute hepatitis A and syphilis, and was found to be negative for hepatitis B surface antigen (HBsAg). Furthermore, he suffered from acute hepatitis B (AH-B) at the age of 21; he was found to be positive for HBsAg and anti-IgM antibody to core antigen (IgM HBcAb). However, he discontinued outpatient treatment before confirmation of HBsAg clearance or the appearance of antibody to HBsAg (HBsAb). At the present admission, HBsAg, antibody to hepatitis B e antigen (HBeAg), and HBcAb were positive, while IgM HBcAb was negative. His genotype of HBV was type A (HBV/A). Histopathological findings of the renal biopsy specimen confirmed glomerulonephritis and glomerular deposition of HBsAg. Thus, he was diagnosed as having nephrotic syndrome caused by membranous nephropathy (MN) associated with chronic hepatitis B (CH-B) following AH-B. Although interferon-alpha (IFN-α) administration was started for the treatment and temporary improvement of proteinuria was observed, remission of MN was not achieved.
著者
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Yotsuyanagi Hiroshi
Department Of Gastroenterology-hepatology St. Marianna Medical College
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YAMADA Norie
Department of Internal Medicine, Division of Gastroenterology and Hepatology, St. Marianna Universit
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Nakahara Kazunari
Department Of Gastroenterology Sendai City Medical Center
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Itoh Fumio
Department Of Gastroenterology And Hepatology St. Marianna Medical University School Of Medicine
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Matsunaga Kotaro
Department Of Pathology Shinshu University School Of Medicine
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Suzuki Michihiro
Department Of Internal Medicine Division Of Gastroenterology And Hepatology St. Marianna University
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Okuse Chiaki
Department Of Internal Medicine Division Of Gastroenterology And Hepatology St. Marianna University
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Kimura Kenjiro
Department Of Biochemistry National Cerebral And Cardiovascular Center Research Institute
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Koike Junki
Department Of Diagnostic Pathology St. Marianna University School Of Medicine
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Takahashi Hideaki
Department Of Biology And Function In Head And Neck Yokohama City University Graduate School Of Medicine
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Shigefuku Ryuta
Department of Internal Medicine, Division of Gastroenterology and Hepatology, St. Marianna University, School of Medicine
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Murao Mei
Department of Internal Medicine, Division of Nephrology and Hypertension, St. Marianna University, School of Medicine
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Yotsuyanagi Hiroshi
Department of Infectious Diseases, Faculty of Medicine, University of Tokyo
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Itoh Fumio
Department of Internal Medicine, Division of Gastroenterology and Hepatology, St. Marianna University, School of Medicine
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Matsunaga Kotaro
Department of Internal Medicine, Division of Gastroenterology and Hepatology, St. Marianna University, School of Medicine
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Yamada Norie
Department of Internal Medicine, Division of Gastroenterology and Hepatology, St. Marianna University, School of Medicine
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Suzuki Michihiro
Department of Internal Medicine, Division of Gastroenterology and Hepatology, St. Marianna University, School of Medicine
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Nakahara Kazunari
Department of Gastroenterology and Hepatology, St. Marianna University Hospital, Japan
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Nakahara Kazunari
Department of Internal Medicine, Division of Gastroenterology and Hepatology, St. Marianna University, School of Medicine
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