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Hcv glomerulonephritis

Petr Husa
Extrahepatic manifestations of hepatitis C virus infection (HCV) are very common. The most common of these is mixed cryoglobulinaemia. Anti-HCV antibodies and viral ribonucleic acid, HCV RNA, can be found in the cryoprecipitates, together with the rheumatoid factor. Cryoglobulins consist of a complex of immunoglobulins that in vitro precipitate upon the cooling bellow the human body temperature. Vasculitis is caused by the deposition of such immune complexes in the small blood vessels. A link with the HCV infection is considered to be established with membranoproliferative glomerulonephritis, leukocytoclastic vasculitis, lymphoproliferative disorders (in particular B cell lymphoma), Sjögren and sicca syndrome, lichen planus, porfyria cutanea tarda and diabetes mellitus...
2016: Vnitr̆ní Lékar̆ství
Patrice Cacoub, Anne Claire Desbois, Corinne Isnard-Bagnis, Dario Rocatello, Clodoveo Ferri
Hepatitis C virus (HCV) infection is associated with tremendous morbidity and mortality due to liver complications. HCV infection is also associated with many extrahepatic manifestations including cardiovascular diseases, glucose metabolism impairment, cryoglobulinemia vasculitis, B cell non-Hodgkin lymphoma and chronic kidney disease (CKD). Many studies have shown a strong association between HCV and CKD, by reporting (i) an increased prevalence of HCV infection in patients on haemodialysis, (ii) an increased incidence of CKD and proteinuria in HCV-infected patients, and (iii) the development of membranoproliferative glomerulonephritis secondary to HCV-induced cryoglobulinemia vasculitis...
October 2016: Journal of Hepatology
Vlad Florin Iovănescu, Adriana Florentina Constantinescu, Costin Teodor Streba, Sorin Ioan Zaharie, Cristin Constantin Vere, Eugen Mandache, Mircea Niculae Penescu, Eugen MoŢa
Chronic viral hepatitis B and C may associate different extrahepatic manifestations and renal disease is the most frequent. Kidney damage is represented in most cases by glomerulopathies, which include membranous nephropathy, membranoproliferative glomerulonephritis (MPGN), IgA nephropathy, focal and segmental glomerulosclerosis and diabetic nephropathy. We conducted a retrospective study on 639 patients diagnosed with chronic viral hepatitis B and C and different renal diseases. Complete evaluation of liver and renal status was performed and, in selected cases, renal biopsy...
2016: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Mariangela Leal Cherchiglia, Luiz Flávio Couto Giordano, Elaine Leandro Machado, Isabel Cristina Gomes, Ricardo Andrade Carmo, Francisco de Assis Acúrcio, Eli Iola Gurgel Andrade, Odilon Viana Queiroz, Carolina Souza Ferreira
The study aimed to estimate the incidence of HCV seroconversion in hemodialysis patients in the Brazilian Unified National Health System (SUS). This was a prospective, non-concurrent study using patients' data identified by deterministic and probabilistic record linkage in the SUS information system. The study included 47,079 patients started on hemodialysis between January 1, 2000, and December 31, 2003, followed until seroconversion or conclusion of the study in 2004. Three percent of hemodialysis patients HCV-seroconverted (1...
August 8, 2016: Cadernos de Saúde Pública
Philipp Blüm, Joachim Pircher, Monika Merkle, Thomas Czermak, Andrea Ribeiro, Hanna Mannell, Florian Krötz, Alexander Hennrich, Michael Spannagl, Simone Köppel, Erik Gaitzsch, Markus Wörnle
Hepatitis C virus (HCV) infection is a major problem worldwide. HCV is not limited to liver disease but is frequently complicated by immune-mediated extrahepatic manifestations such as glomerulonephritis or vasculitis. A fatal complication of HCV-associated vascular disease is thrombosis. Polyriboinosinic:polyribocytidylic acid (poly (I:C)), a synthetic analog of viral RNA, induces a Toll-like receptor 3 (TLR3)-dependent arteriolar thrombosis without significant thrombus formation in venules in vivo. These procoagulant effects are caused by increased endothelial synthesis of tissue factor and PAI-1 without platelet activation...
April 18, 2016: Cellular & Molecular Immunology
Kyung-Ah Kim
The landscape of treatment for HCV infection has evolved substantially with the advent of highly effective direct-acting antiviral agents (DAA). The Korean Association for the Study of the Liver updated guideline for managemnt of hepatitis C in accordance with the introduction of DAA into practice in late 2015. Due to high effectiveness and few side effects of DAA, indications for treatment has been widened to include patients who had been contraindicated for the combination treatment of peginterferon-α and ribavirin, i...
March 2016: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
Franco Dammacco, Vito Racanelli, Sabino Russi, Domenico Sansonno
Cryoglobulinemic vasculitis (CV) is a small-to-medium-vessel vasculitis that appears in 10-15 % of patients chronically infected with hepatitis C virus (HCV). The classic symptom triad of CV, purpura/asthenia/arthralgia, is accompanied by clinical features that include glomerulonephritis, neuropathy, interstitial pneumonitis, and cardiomyopathy, ranging in their severity from mild to life threatening. The risk of developing non-Hodgkin lymphoma is also higher. The cumulative 10-year survival rate of CV patients is significantly lower than in the age- and sex-matched general population, with death typically caused by nephropathy, malignancies, liver involvement, and severe infections...
August 2016: Clinical and Experimental Medicine
David Saadoun, Vincent Thibault, Si Nafa Si Ahmed, Laurent Alric, Maxime Mallet, Constance Guillaud, Hassane Izzedine, Aurélie Plaisier, Hélène Fontaine, Myrto Costopoulos, Magali Le Garff-Tavernier, Christophe Hezode, Stanislas Pol, Lucile Musset, Thierry Poynard, Patrice Cacoub
BACKGROUND: Hepatitis C virus (HCV) is the aetiological agent for most cases of cryoglobulinaemia vasculitis. Interferon-containing regimens are associated with important side effects and may exacerbate the vasculitis. OBJECTIVE: To evaluate safety and efficacy of an oral interferon-free regimen, sofosbuvir plus ribavirin, in HCV-cryoglobulinaemia vasculitis. PATIENTS AND METHODS: We enrolled 24 consecutive patients (median age of 56.5 years and 46% of women) with HCV-cryoglobulinaemia vasculitis...
October 2016: Annals of the Rheumatic Diseases
Meghan E Sise, Allyson K Bloom, Jessica Wisocky, Ming V Lin, Jenna L Gustafson, Andrew L Lundquist, David Steele, Michael Thiim, Winfred W Williams, Nikroo Hashemi, Arthur Y Kim, Ravi Thadhani, Raymond T Chung
UNLABELLED: Hepatitis C virus (HCV) is the most common cause of mixed cryoglobulinemia syndrome (MCS). The efficacy and safety of all-oral direct-acting antiviral (DAA) therapy in HCV-associated MCS (HCV-MCS) is largely unknown. The authors studied case series of patients with HCV-MCS who were treated with sofosbuvir-based regimens and historical controls treated with pegylated interferon and ribavirin in a single health care network. HCV-MCS was defined by circulating cryoglobulin associated with systemic vasculitis symptoms...
February 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Alpha Oumar Bah, Cisse Lamine, Mamadou Cellou Balde, Mamadou Lamine Yaya Bah, Lionel Rostaing
BACKGROUND: Chronic kidney disease (CKD) is increasing worldwide and can lead to end-stage renal disease (ESRD). OBJECTIVES: Because few patients with ESRD in the Republic of Guinea have access to haemodialysis, we retrospectively evaluated the prevalence of CKD, ESRD and access to supportive therapies. PATIENTS AND METHODS: 579 CKD patients (304 males; mean age: 44 ± 16 years) were admitted into Conakry nephrology department, the only centre in the Republic of Guinea, between 2009 and 2013...
October 2015: Journal of Nephropathology
Anaïs Vallet-Pichard, Stanislas Pol
Chronic infections by hepatitis B (HBV) and C virus (HCV) result in diagnosis and therapeutic issues in dialysis and kidney recipients patients. The exposure to nosocomial, including blood transfusion, risk explains the high prevalence of HBV and HCV infection in this setting. Chronic infection reduces the survival of both patients and allografts, including a specific risk of de novo glomerulonephritis. Cirrhosis was considered as a contra-indication to renal transplantation given the high risk of decompensation and death, questionning the indication of a combined liver and kidney transplantation...
November 2015: Néphrologie & Thérapeutique
Ikuyo Narita, Michiko Shimada, Takeshi Fujita, Reiichi Murakami, Masayuki Nakamura, Norio Nakamura, Hideaki Yamabe, Ken Okumura
BACKGROUND: It is sometimes challenging to diagnose unsusual cases of fibrillary glomerulonephritis (FGN) and immunotactoid glomerulopathy (ITG), the rare causes of nephrotic syndrome. CASE PRESENTATION: A 75-year-old Japanese woman presented with nephrotic syndrome, microhematuria and renal insufficiency. Renal biopsy revealed membranoproliferative glomerulonephritis (MPGN) with IgM and weak C3 deposition. Congo red stain was negative. Electron microscopy demonstrated massive fibrils in the subendothelium, mesangium and subepithelium...
2015: BMC Nephrology
L-J Zhao, F Chen, J-G Li, R Yin, X-H Zhang, S-M Huang, F Liu
OBJECTIVE: Chronic HCV (hepatitis C virus) infection is recognized as the major cause of mixed cryoglobulinemia. Cryoglobulins continually precipitate and form deposits on the vascular endothelium of small to medium-sized blood vessels, which may progress to vasculitic syndrome. CASE REPORT: A 44-year-old female patient with chronic HCV infection presented with purpuras, edema and proteinuria. Her renal findings included microscopic hematuria, moderate proteinuria and endocapillary proliferative glomerulonephritis (EnPGN) on renal biopsy...
August 2015: European Review for Medical and Pharmacological Sciences
R Ennaifer, M Sabbah, R Hefaiedh, H Romdhane, M Cheikh, N Belhadj
No abstract text is available yet for this article.
March 2015: La Tunisie Médicale
Tomoyuki Otsuka, Yukinao Sakai, Dai Ohno, Shuichi Tsuruoka
A 61-year-old man with bilateral purpura of the lower limbs and subsequent edema, was hospitalization after renal dysfunction developed. The presence of hepatitis C virus (HCV) RNA and cryoglobulin and the finding of membranoproliferative glomerulonephritis on renal biopsy led to a diagnosis of HCV-related glomerulonephritis due to cryoglobulinemia. Because of the pre-existence of nephrotic syndrome and the continuously increasing serum level of creatinine, treatment with cryofiltration, interferon, and steroids was started...
2015: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
Benjamin Terrier, Isabelle Marie, Adeline Lacraz, Pauline Belenotti, Fabrice Bonnet, Laurent Chiche, Bruno Graffin, Arnaud Hot, Jean-Emmanuel Kahn, Catherine Michel, Thomas Quemeneur, Luc de Saint-Martin, Olivier Hermine, Jean-Marc Léger, Xavier Mariette, Patricia Senet, Emmanuelle Plaisier, Patrice Cacoub
In patients with infectious cryoglobulinemia vasculitis (CryoVas) in the absence of hepatitis C virus infection, data on presentation, therapeutic management and outcome are lacking. We conducted a nationwide survey that included patients with HCV-negative CryoVas. We describe here the presentation, therapeutic management and outcome of 18 patients with non-HCV infectious CryoVas and 27 additional patients identified form a systematic review of the literature. We included 18 patients, mean age 57.9±13.5 years...
December 2015: Journal of Autoimmunity
Francesco Negro, Daniel Forton, Antonio Craxì, Mark S Sulkowski, Jordan J Feld, Michael P Manns
Chronic hepatitis C virus (HCV) infection is associated with several extrahepatic manifestations. Patients with HCV may develop mixed cryoglobulinemia and its sequelae, ranging from cutaneous and visceral vasculitis to glomerulonephritis and B-cell non-Hodgkin lymphoma. HCV-infected patients have increased rates of insulin resistance, diabetes, and atherosclerosis, which may lead to increased cardiovascular morbidity and mortality. Neurological manifestations of HCV infection include fatigue and cognitive impairment...
November 2015: Gastroenterology
Anu Gupta, Richard J Quigg
Infections with hepatitis B virus (HBV) and hepatitis C virus (HCV) are prevalent worldwide. In this review, we discuss the epidemiology, pathogenesis, clinical manifestations, and treatment of HBV- and HCV-related glomerulonephritis (GN). The most common histopathologic presentation of HBV-GN is HBV-associated membranous nephropathy, which usually manifests clinically with varying grades of proteinuria and microscopic hematuria. The pathogenesis is likely to be immune complex mediated; however, other host and viral factors have been implicated...
September 2015: Advances in Chronic Kidney Disease
Fabrizio Fabrizi, Donata Cresseri, Giovanni B Fogazzi, Gabriella Moroni, Patrizia Passerini, Paul Martin, Piergiorgio Messa
The evidence in the medical literature on the efficacy and safety of rituximab therapy for primary glomerulonephritis is limited and controversial. We describe two male Caucasian patients with rapidly progressive kidney failure due to primary proliferative glomerulonephritis. Both of them received high-dose intravenous corticosteroids and oral cyclophosphamide with limited benefit. The first patient (hepatitis C virus-negative mixed cryoglobulinemia) underwent plasma-exchange with intravenous immunoglobulins; he showed significant benefit on kidney function (he became dialysis independent with serum creatinine going back to 1...
August 16, 2015: World Journal of Clinical Cases
Salvatore Scarpato, Fabiola Atzeni, Piercarlo Sarzi-Puttini, Antonio Brucato, Luca Quartuccio, Maurizio Pietrogrande, Giuseppe Monti, Massimo Galli
Cryoglobulinaemic syndrome (CS) includes clinical signs and symptoms that range from the classic triad of Meltzer and Franklin (purpura, weakness and arthralgias) to multiple organ involvement, and it may be characterised by nociceptive or neuropathic pain. Both types of pain use the same pathways and neurotransmitters, but nociceptive pain has an adaptive system and biological function whereas neuropathic pain does not. Managing CS means dealing with often very different clinical patterns, activity and severity with the aim of preventing irreversible organ damage, reducing pain, improving the patients' quality of life and reducing social costs...
February 2015: Best Practice & Research. Clinical Rheumatology
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