Successful treatment of HCV-related cryoglobulinemic glomerulonephritis with double-filtration plasmapheresis and interferon combination therapy |
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Authors: | Tomoko Namba Rie Shiba Takeshi Yamamoto Yasuhiro Hirai Takuma Moriwaki Jun Matsuda Hiroyuki Kadoya Masanobu Takeji Yukinori Yamada Harumasa Yoshihara Atsushi Yamauchi |
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Institution: | 1. Division of Nephrology, Osaka Rosai Hospital, 1179-3 Nagasone-cho, Sakai, Osaka, 591-8025, Japan 2. Division of Gastroenterology, Osaka Rosai Hospital, Osaka, Japan 3. Division of Clinical Engineering, Osaka Rosai Hospital, Osaka, Japan
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Abstract: | A 67-year-old, hepatitis C virus (HCV)-positive woman was admitted to our hospital because of proteinuria and leg edema. Laboratory examination showed decreased serum albumin and complement activity and positive cryoglobulin. The HCV RNA genotype was 1b with high viral load. Kidney biopsy showed membranoproliferative glomerulonephritis (MPGN) with capillary deposition of C3, IgM, and IgG, indicating HCV-associated glomerulonephritis. In addition to interferon (IFN) therapy, double-filtration plasmapheresis (DFPP) was performed to reduce HCV RNA blood levels in the early stage of IFN therapy. This treatment greatly reduced the viral load and induced clinical remission of MPGN, suggesting that DFPP plus IFN combination therapy may represent a potentially effective modality for refractory-type HCV-associated glomerulonephritis. |
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