Korean J Hepatol.  2001 Dec;7(4):413-422.

Histopathologic Correlation between Chronic Hepatitis B and Nephropathy

• Lee HW
• Chon CY
• Park YN
• Lee KS
• Ahn SH
• Choi CH
• Park YS
• Cheong JW
• Sohn JH
• Cheong JY
• Song KH
• Han KH
• Moon YM

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.

Keyword

Heaptitis/Viral/Chronic Hepatitis B; Liver biopsy; Nephropathy; Renal biopsy

MeSH Terms

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
Hepatitis B Surface Antigens
Hepatitis B e Antigens
Immunoglobulin G