Renal involvement in hepatitis C infection: Cryoglobulinemic glomerulonephritis - Discussion

被引：199

作者：

D'Amico, G

Madias, NE

Fornasieri, A

Ferri, C

Sansonno, D

Bombardieri, S

Invernizzi, F

Monti, G

Misiani, R

Monteverde, A

Merlini, G

Andreucci, V

Moriconi, L

Cinotti, G

Schena, FP

Ponticelli, C

Piccoli, G

Fuiano, G

Roccatello, D

Coppo, R

Tarantino, A

机构：

[1] San Carlo Borromeo Hosp, Div Nephrol, I-20153 Milano, Italy

[2] New England Med Ctr, Div Nephrol, Boston, MA 02111 USA

[3] Univ Pisa, Dept Med & Clin Immunol, I-56100 Pisa, Italy

[4] Univ Bari, Dept Med, I-70121 Bari, Italy

[5] Univ Pisa, Dept Med, Clin Immunol Sect, I-56100 Pisa, Italy

[6] Univ Milan, Inst Biomed Sci, I-20122 Milan, Italy

[7] S Paolo Hosp, Milan, Italy

[8] Hosp Saronno, Dept Med, Saronno, Italy

[9] Osped Riuniti Bergamo, Div Nephrol, I-24100 Bergamo, Italy

[10] Univ Pavia, Dept Internal Med & Clin Oncol, I-27100 Pavia, Italy

[11] Univ Naples, Inst Nephrol, I-80138 Naples, Italy

[12] S Chiara Hosp, Div Nephrol, Pisa, Italy

[13] Univ Rome, Inst Nephrol, Rome, Italy

[14] Univ Bari, Inst Nephrol, I-70121 Bari, Italy

[15] Osped Maggiore, Div Nephrol, Milan, Italy

[16] Univ Turin, Inst Nephrol, I-10124 Turin, Italy

[17] G Bosco Hosp, Div Nephrol, Turin, Italy

[18] Regina Elena Hosp, Div Pediat Nephrol, Turin, Italy

来源：

KIDNEY INTERNATIONAL | 1998年 / 54卷 / 02期

关键词：

hepatitis C virus; renal vasculitis; mixed cryoglobulinemia; membranoproliferative GN;

D O I：

10.1046/j.1523-1755.1998.00028.x

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Cryoglobulinemic glomerulonephritis, the most frequent renal complication of HCV infection, is associated with type-II mixed cryoglobulinemia, IgMκ being usually the monoclonal rheumatoid factor. This membranoproliferative GN, which shows some distinctive histologic features (intraglomerular monocyte infiltration, intraluminal thrombi due to massive precipitation of cryoglobulins, renal vasculitis), has a chronic clinical course with recurrent acute episodes that can be controlled by corticosteroids and cyclophosphamide more than by antiviral therapy (interferon-alpha). The affinity of the circulating IgMκ RF for the mesangium appears to be the major factor responsible for the precipitation of type-II mixed cryoglobulins in the glomerular structures and the ensuing damage.

引用

页码：650 / 671

页数：22

共 88 条

[1] HEPATITIS-C VIRUS-INFECTION IN TYPE-II MIXED CRYOGLOBULINEMIA [J].