Membranoproliferative Glomerulonephritis and Mixed Cryoglobulinemia after Hepatitis C Virus Infection Secondary to Glomerular NS3 Viral Antigen Deposits
Background: We report on 3 cases of membranoproliferative glomerulonephritis associated with mixed cryoglobulin in patients with hepatitis C virus (HCV) antibodies but a negative blood viral load. These cases explore the pathogenesis of the renal disease. Methods: We searched for occult HCV infectio...
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| Veröffentlicht in: | American journal of nephrology 2012-02, Vol.35 (2), p.134-140 |
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| creator | Bataille, Stanislas Kaplanski, Gilles Boucraut, José Halfon, Philippe Camus, Claire Daniel, Laurent Burtey, Stéphane Berland, Yvon Dussol, Bertrand |
| description | Background: We report on 3 cases of membranoproliferative glomerulonephritis associated with mixed cryoglobulin in patients with hepatitis C virus (HCV) antibodies but a negative blood viral load. These cases explore the pathogenesis of the renal disease. Methods: We searched for occult HCV infection in peripheral blood mononuclear cells, cryoprecipitate, bone marrow cells, and glomeruli using ultrasensitive PCR assays and immunohistochemistry. We also looked for infraclinical B cell lymphoma by computed tomodensitometry, bone marrow aspiration and biopsy, and lymphocyte typing. Results: By PCR assays, we did not evidence occult hepatitis C infection in peripheral blood mononuclear cells, bone marrow cells, or cryoprecipitates. In the only patient with available kidney specimen, we evidenced HCV-NS3 antigen in glomeruli. HCV-associated lymphoma was excluded, but mild polyclonal B lymphocytosis was present in the 3 patients. Remission occurred spontaneously in 1 patient, and in another patient it occurred after rituximab treatment. The third patient was lost to follow-up. Conclusions: In patients with hepatitis C-negative viral load, membranoproliferative glomerulonephritis could be induced by the persistence of HCV antigen in the kidney but not in hematopoietic cells. Nonlymphomatous B cell proliferation may also be induced by chronic viral stimulation. |
| doi_str_mv | 10.1159/000335375 |
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These cases explore the pathogenesis of the renal disease. Methods: We searched for occult HCV infection in peripheral blood mononuclear cells, cryoprecipitate, bone marrow cells, and glomeruli using ultrasensitive PCR assays and immunohistochemistry. We also looked for infraclinical B cell lymphoma by computed tomodensitometry, bone marrow aspiration and biopsy, and lymphocyte typing. Results: By PCR assays, we did not evidence occult hepatitis C infection in peripheral blood mononuclear cells, bone marrow cells, or cryoprecipitates. In the only patient with available kidney specimen, we evidenced HCV-NS3 antigen in glomeruli. HCV-associated lymphoma was excluded, but mild polyclonal B lymphocytosis was present in the 3 patients. Remission occurred spontaneously in 1 patient, and in another patient it occurred after rituximab treatment. The third patient was lost to follow-up. Conclusions: In patients with hepatitis C-negative viral load, membranoproliferative glomerulonephritis could be induced by the persistence of HCV antigen in the kidney but not in hematopoietic cells. Nonlymphomatous B cell proliferation may also be induced by chronic viral stimulation.</description><identifier>ISSN: 0250-8095</identifier><identifier>EISSN: 1421-9670</identifier><identifier>DOI: 10.1159/000335375</identifier><identifier>PMID: 22248563</identifier><identifier>CODEN: AJNED9</identifier><language>eng</language><publisher>Basel, Switzerland: S. Karger AG</publisher><subject>Adult ; Antibodies ; Antigens, Viral - adverse effects ; Antigens, Viral - isolation & purification ; B-Lymphocytes ; Biopsy ; Bone marrow ; Cell proliferation ; Cryoglobulinemia ; Cryoglobulinemia - immunology ; Cryoglobulinemia - virology ; Cryoglobulins ; Cryoprecipitates ; Deposits ; double prime B-cell lymphoma ; Glomerulonephritis ; Glomerulonephritis, Membranoproliferative - immunology ; Glomerulonephritis, Membranoproliferative - virology ; Hemopoiesis ; Hepacivirus - immunology ; Hepacivirus - isolation & purification ; Hepatitis C ; Hepatitis C - complications ; Hepatitis C virus ; Humans ; Immunohistochemistry ; Kidney diseases ; Lymphocyte typing ; Lymphocytes B ; Lymphocytosis ; Lymphocytosis - complications ; Male ; Middle Aged ; Original Report: Patient-Oriented, Translational Research ; Peripheral blood mononuclear cells ; Polymerase chain reaction ; Remission ; rituximab ; Viral Load ; Viral Nonstructural Proteins - immunology</subject><ispartof>American journal of nephrology, 2012-02, Vol.35 (2), p.134-140</ispartof><rights>2012 S. Karger AG, Basel</rights><rights>Copyright © 2012 S. Karger AG, Basel.</rights><rights>Copyright (c) 2012 S. Karger AG, Basel</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c365t-7eb938f0f53b52adc6f36a3b8123242def3720988b31bb0234e5b3088e23ee173</citedby><cites>FETCH-LOGICAL-c365t-7eb938f0f53b52adc6f36a3b8123242def3720988b31bb0234e5b3088e23ee173</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,2427,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22248563$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bataille, Stanislas</creatorcontrib><creatorcontrib>Kaplanski, Gilles</creatorcontrib><creatorcontrib>Boucraut, José</creatorcontrib><creatorcontrib>Halfon, Philippe</creatorcontrib><creatorcontrib>Camus, Claire</creatorcontrib><creatorcontrib>Daniel, Laurent</creatorcontrib><creatorcontrib>Burtey, Stéphane</creatorcontrib><creatorcontrib>Berland, Yvon</creatorcontrib><creatorcontrib>Dussol, Bertrand</creatorcontrib><title>Membranoproliferative Glomerulonephritis and Mixed Cryoglobulinemia after Hepatitis C Virus Infection Secondary to Glomerular NS3 Viral Antigen Deposits</title><title>American journal of nephrology</title><addtitle>Am J Nephrol</addtitle><description>Background: We report on 3 cases of membranoproliferative glomerulonephritis associated with mixed cryoglobulin in patients with hepatitis C virus (HCV) antibodies but a negative blood viral load. These cases explore the pathogenesis of the renal disease. Methods: We searched for occult HCV infection in peripheral blood mononuclear cells, cryoprecipitate, bone marrow cells, and glomeruli using ultrasensitive PCR assays and immunohistochemistry. We also looked for infraclinical B cell lymphoma by computed tomodensitometry, bone marrow aspiration and biopsy, and lymphocyte typing. Results: By PCR assays, we did not evidence occult hepatitis C infection in peripheral blood mononuclear cells, bone marrow cells, or cryoprecipitates. In the only patient with available kidney specimen, we evidenced HCV-NS3 antigen in glomeruli. HCV-associated lymphoma was excluded, but mild polyclonal B lymphocytosis was present in the 3 patients. Remission occurred spontaneously in 1 patient, and in another patient it occurred after rituximab treatment. The third patient was lost to follow-up. Conclusions: In patients with hepatitis C-negative viral load, membranoproliferative glomerulonephritis could be induced by the persistence of HCV antigen in the kidney but not in hematopoietic cells. Nonlymphomatous B cell proliferation may also be induced by chronic viral stimulation.</description><subject>Adult</subject><subject>Antibodies</subject><subject>Antigens, Viral - adverse effects</subject><subject>Antigens, Viral - isolation & purification</subject><subject>B-Lymphocytes</subject><subject>Biopsy</subject><subject>Bone marrow</subject><subject>Cell proliferation</subject><subject>Cryoglobulinemia</subject><subject>Cryoglobulinemia - immunology</subject><subject>Cryoglobulinemia - virology</subject><subject>Cryoglobulins</subject><subject>Cryoprecipitates</subject><subject>Deposits</subject><subject>double prime B-cell lymphoma</subject><subject>Glomerulonephritis</subject><subject>Glomerulonephritis, Membranoproliferative - immunology</subject><subject>Glomerulonephritis, Membranoproliferative - virology</subject><subject>Hemopoiesis</subject><subject>Hepacivirus - immunology</subject><subject>Hepacivirus - isolation & purification</subject><subject>Hepatitis C</subject><subject>Hepatitis C - complications</subject><subject>Hepatitis C virus</subject><subject>Humans</subject><subject>Immunohistochemistry</subject><subject>Kidney diseases</subject><subject>Lymphocyte typing</subject><subject>Lymphocytes B</subject><subject>Lymphocytosis</subject><subject>Lymphocytosis - complications</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Original Report: Patient-Oriented, Translational Research</subject><subject>Peripheral blood mononuclear cells</subject><subject>Polymerase chain reaction</subject><subject>Remission</subject><subject>rituximab</subject><subject>Viral Load</subject><subject>Viral Nonstructural Proteins - immunology</subject><issn>0250-8095</issn><issn>1421-9670</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp90U1v1DAQBmALgehSOHBHyOLScgj4I07sY7WFtlILhwLXyE7Gi0tiB9up6D_h5-LVLnvgwGkuz7zSzIvQS0reUSrUe0II54K34hFa0ZrRSjUteYxWhAlSSaLEEXqW0h0hlEnSPkVHjLFaioav0O8bmEzUPswxjM5C1NndA74YwwRxGYOH-Xt02SWs_YBv3C8Y8Do-hM0YzDI6D5PTWNsMEV_CXJa3dI2_ubgkfOUt9NkFj2-hD37Q8QHncAjXEX-65VurR3zms9uAx-cwh-Ryeo6eWD0meLGfx-jrxw9f1pfV9eeLq_XZddXzRuSqBaO4tMQKbgTTQ99Y3mhuJGWc1WwAy1tGlJSGU2MI4zUIw4mUwDgAbfkxOtnllgf8XCDlbnKph3HUHsKSOsU4VaRhqsjT_0pKaE1JLSUt9M0_9C4s0Zc7OqWYqpUS27y3O9THkFIE283RTeVHJanb9todei329T5wMRMMB_m3yAJe7cAPHTcQD2C__wd_dKeU</recordid><startdate>201202</startdate><enddate>201202</enddate><creator>Bataille, Stanislas</creator><creator>Kaplanski, Gilles</creator><creator>Boucraut, José</creator><creator>Halfon, Philippe</creator><creator>Camus, Claire</creator><creator>Daniel, Laurent</creator><creator>Burtey, Stéphane</creator><creator>Berland, Yvon</creator><creator>Dussol, Bertrand</creator><general>S. 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adverse effects</topic><topic>Antigens, Viral - isolation & purification</topic><topic>B-Lymphocytes</topic><topic>Biopsy</topic><topic>Bone marrow</topic><topic>Cell proliferation</topic><topic>Cryoglobulinemia</topic><topic>Cryoglobulinemia - immunology</topic><topic>Cryoglobulinemia - virology</topic><topic>Cryoglobulins</topic><topic>Cryoprecipitates</topic><topic>Deposits</topic><topic>double prime B-cell lymphoma</topic><topic>Glomerulonephritis</topic><topic>Glomerulonephritis, Membranoproliferative - immunology</topic><topic>Glomerulonephritis, Membranoproliferative - virology</topic><topic>Hemopoiesis</topic><topic>Hepacivirus - immunology</topic><topic>Hepacivirus - isolation & purification</topic><topic>Hepatitis C</topic><topic>Hepatitis C - complications</topic><topic>Hepatitis C virus</topic><topic>Humans</topic><topic>Immunohistochemistry</topic><topic>Kidney diseases</topic><topic>Lymphocyte typing</topic><topic>Lymphocytes B</topic><topic>Lymphocytosis</topic><topic>Lymphocytosis - complications</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Original Report: Patient-Oriented, Translational Research</topic><topic>Peripheral blood mononuclear cells</topic><topic>Polymerase chain reaction</topic><topic>Remission</topic><topic>rituximab</topic><topic>Viral Load</topic><topic>Viral Nonstructural Proteins - immunology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bataille, Stanislas</creatorcontrib><creatorcontrib>Kaplanski, Gilles</creatorcontrib><creatorcontrib>Boucraut, José</creatorcontrib><creatorcontrib>Halfon, Philippe</creatorcontrib><creatorcontrib>Camus, Claire</creatorcontrib><creatorcontrib>Daniel, Laurent</creatorcontrib><creatorcontrib>Burtey, Stéphane</creatorcontrib><creatorcontrib>Berland, Yvon</creatorcontrib><creatorcontrib>Dussol, Bertrand</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Science Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of nephrology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bataille, Stanislas</au><au>Kaplanski, Gilles</au><au>Boucraut, José</au><au>Halfon, Philippe</au><au>Camus, Claire</au><au>Daniel, Laurent</au><au>Burtey, Stéphane</au><au>Berland, Yvon</au><au>Dussol, Bertrand</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Membranoproliferative Glomerulonephritis and Mixed Cryoglobulinemia after Hepatitis C Virus Infection Secondary to Glomerular NS3 Viral Antigen Deposits</atitle><jtitle>American journal of nephrology</jtitle><addtitle>Am J Nephrol</addtitle><date>2012-02</date><risdate>2012</risdate><volume>35</volume><issue>2</issue><spage>134</spage><epage>140</epage><pages>134-140</pages><issn>0250-8095</issn><eissn>1421-9670</eissn><coden>AJNED9</coden><abstract>Background: We report on 3 cases of membranoproliferative glomerulonephritis associated with mixed cryoglobulin in patients with hepatitis C virus (HCV) antibodies but a negative blood viral load. These cases explore the pathogenesis of the renal disease. Methods: We searched for occult HCV infection in peripheral blood mononuclear cells, cryoprecipitate, bone marrow cells, and glomeruli using ultrasensitive PCR assays and immunohistochemistry. We also looked for infraclinical B cell lymphoma by computed tomodensitometry, bone marrow aspiration and biopsy, and lymphocyte typing. Results: By PCR assays, we did not evidence occult hepatitis C infection in peripheral blood mononuclear cells, bone marrow cells, or cryoprecipitates. In the only patient with available kidney specimen, we evidenced HCV-NS3 antigen in glomeruli. HCV-associated lymphoma was excluded, but mild polyclonal B lymphocytosis was present in the 3 patients. Remission occurred spontaneously in 1 patient, and in another patient it occurred after rituximab treatment. The third patient was lost to follow-up. Conclusions: In patients with hepatitis C-negative viral load, membranoproliferative glomerulonephritis could be induced by the persistence of HCV antigen in the kidney but not in hematopoietic cells. Nonlymphomatous B cell proliferation may also be induced by chronic viral stimulation.</abstract><cop>Basel, Switzerland</cop><pub>S. Karger AG</pub><pmid>22248563</pmid><doi>10.1159/000335375</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Antibodies Antigens, Viral - adverse effects Antigens, Viral - isolation & purification B-Lymphocytes Biopsy Bone marrow Cell proliferation Cryoglobulinemia Cryoglobulinemia - immunology Cryoglobulinemia - virology Cryoglobulins Cryoprecipitates Deposits double prime B-cell lymphoma Glomerulonephritis Glomerulonephritis, Membranoproliferative - immunology Glomerulonephritis, Membranoproliferative - virology Hemopoiesis Hepacivirus - immunology Hepacivirus - isolation & purification Hepatitis C Hepatitis C - complications Hepatitis C virus Humans Immunohistochemistry Kidney diseases Lymphocyte typing Lymphocytes B Lymphocytosis Lymphocytosis - complications Male Middle Aged Original Report: Patient-Oriented, Translational Research Peripheral blood mononuclear cells Polymerase chain reaction Remission rituximab Viral Load Viral Nonstructural Proteins - immunology |
| title | Membranoproliferative Glomerulonephritis and Mixed Cryoglobulinemia after Hepatitis C Virus Infection Secondary to Glomerular NS3 Viral Antigen Deposits |
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