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KMID : 0191119980130060670
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Journal of Korean Medical Science
1998 Volume.13 No. 6 p.670 ~ p.675
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Membranoproliferative glomerulonephritis associated with HCV infection in native kidneys and renal allograft
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Jeong HJ
Choi KH/Chon CY/Kim SI/Park K
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Abstract
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Hepatitis C viral infection occurs relatively low in Korea compared to hepatitis B. However, it progresses
into chronic hepatitis and cirrhosis more frequently than HBV. It may be associated with cryoglobulinemia
and glomerulonephritis, both in native and transplanted kidneys. We report three cases of membrano-proliferative
glomerulonephritis type I in anti-HCV positive, but cryoglobulin-negative patients, presenting massive
proteinuria, two in native kidneys and one in an allograft. HCV-RNA was positive in sera of two patients.
Two were cirrhotic and ALT was mildly elevated in two. In addition to the characteristic membranoproliferative
feature, two native kidneys overlapped with features of diabetic nephropathy. Immunofluorescence demonstrated
mainly IgM and C3 deposits along the peripheral capillary walls. Subendothelial electron dense deposits were
present in the glomeruli of all three cases with subepithelial and intramembranous deposits in two. HCV-RNA
was associated not only with a greater amount of immune deposits but also with subepithelial and intramembranous
deposits, indicating the role of active infection.
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