Cryoglobulinemic glomerulonephritis in chronic hepatitis B infection

Abstract

Hepatitis B virus (HBV) infection is an uncommon cause of cryoglobulinemia. Renal cryoglobulinemia has been rarely reported in the setting of chronic hepatitis B infection. We describe a case of chronic hepatitis B infection with cryoglobulinemic glomerulonephritis (Gn) and provide information about the treatment and the evolution over a 30-month follow-up. A 41-year-old woman with chronic hepatitis B infection developed nephrotic syndrome and acute renal failure; other investigations revealed type 2 cryoglobulinemia; HBV DNA was detected in the cryoprecipitate. Renal biopsy showed findings of cryoglobulinemic Gn. She was given lamivudine, corticosteroids, plasma exchange, and mycophenolate mofetil. The renal function improved, nephrotic syndrome remitted, and HBV DNA became undetectable; there was no compromise of the liver function.

Keywords:

• acute renal failure
• cryoglobulinemia
• glomerulonephritis
• nephrotic syndrome
• hepatitis B

Acknowledgments

We thank prof. J. Forteza (Pathology Department, Hospital Clínico Universitario, Santiago de Compostela) for his assistance with electron microscopy study.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.