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Clinicopathologicaland teatures and treatment of hepatitis B virus associated glomerulonephritis

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Author:
XIAO Feng-lin(Department of Nephrology, Navy General Hospital, Beijing 100048, China)
ZHOU Chun-hua(Department of Nephrology, Navy General Hospital, Beijing 100048, China)
Journal Title:
China Medicine
Issue:
Volume 07, Issue 07, 2012
DOI:
10.3760/cma.j.issn.1673-4777.2012.07.020
Key Word:
Glomerulonephritis,hepatitis B virus associated;Hepatitis B;Pathological characters

Abstract: Objective To explore the clinical features and curative effect of Hepatitis B virus associated glomerulonephritis(HBV-GN).Methods The pathology,clinical manifestation of 21 HBV-GN potients diagnosed by renal biopsy were analyzed.HBsAg,anty-HBs,anty-HBc,HBeAg,anti-HBe and urine protein in 24 hours were assayed.HBsAg and HBcAg of nephridial tissue were detected by immunohistochemical method.The treatment of hormone combined of mycophenolate mofetil or leflunomide,or ciclosporin A were used and the therapeulic effect was assessed.Results There were 21 patients diagnosed of HBV-GN.The ratio of male:female was 6:1.The clinical symptom of 8 patients(38.1%) was nephrotic syndrome and HBV-DNA positive rate was 9.5%(2/21).Of 21 cases,8 cases were with membranous glomerulonephrilis,6 cases with mesangial proliferative glomerulonephritis,4 cases with IgA nephropathy and 3 cases with membrane proliferative glomendonephritis.The positive rate of HBsAg and HBcAg in kidney tissues was 71.4%(15/21) and 85.7%(18/21).Of seven patients treated with hormone combined with leflunomide,the condition of 2 cases was complete remission,and others were partial remission.The total effective rate was 85.7%(18/21).Conclusions HBV-GN is more common in male.The most common clinical symptom is nephrotic syndrome,and membranous glomerulonephritis is the most frequent pathological type.Hormone combined leflunomide has some effect in the treatment of HBV-GN.

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