A case of rapid amelioration of hepatitis C virus-associated cryoglobulinemic membranoproliferative glomerulonephritis treated by interferon-free directly acting antivirals for HCV in the absence of immunosuppressant

CEN Case Reports
Fumiaki ObataToshio Doi

Abstract

Mixed cryoglobulinemic syndrome, which is a systemic vasculitis characterized by the immune complex deposition in small- and medium-sized arteries and most often due to chronic hepatitis C virus (HCV) infection, sometimes clinically manifests as refractory glomerulonephritis or nephritic syndrome. Patients with mixed cryoglobulinemic nephropathy who have a rapidly progressive glomerulonephritis should receive immunosuppressive therapy. After disease stabilization, patients should receive concurrent therapy for the underlying HCV infection. The standard therapy of a chronic HCV infection is IFN monotherapy or IFN combined with ribavirin; however, after the introduction of direct-acting antivirals (DAAs), the standard therapy for patients with HCV genotype 1 has dramatically changed. We report a case of HCV-associated cryoglobulinemic membranoproliferative glomerulonephritis (MPGN) successfully treated by daclatasvir and asunaprevir, which are IFN-free DAAs for HCV, in combination with angiotensin II receptor blocker without immunosuppressive therapy. The patient developed severe nephrotic syndrome with progressive kidney dysfunction. Blood examination revealed a high copy number of HCV-RNA (6.4 log IU/mL, type 1), cryoglobulinem...Continue Reading

References

Dec 1, 1989·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·J V Donadio, K P Offord
Mar 17, 1994·The New England Journal of Medicine·R MisianiG Vendramin
Jul 7, 2001·The New England Journal of Medicine·G M Lauer, B D Walker
Oct 9, 2002·The Journal of Immunology : Official Journal of the American Association of Immunologists·Shuichi KikuchiShozo Izui
May 5, 2007·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Rashad S Barsoum
Jul 17, 2010·Liver International : Official Journal of the International Association for the Study of the Liver·Tarik AsselahPatrick Marcellin
Jun 28, 2011·Nihon Naika Gakkai zasshi. The Journal of the Japanese Society of Internal Medicine·Seiji Kishi, Toshio Doi
Oct 12, 2011·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Kazuaki ChayamaHiromitsu Kumada
Apr 24, 2013·The New England Journal of Medicine·Eric LawitzEdward J Gane
Mar 8, 2014·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Hiromitsu KumadaEric Hughes
Jul 20, 2014·Annals of the Rheumatic Diseases·Jonathan G StineNeeral L Shah

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Citations

Jan 24, 2018·World Journal of Hepatology·Elizabeth S AbyJihane N Benhammou
Mar 20, 2020·BMJ Case Reports·Tsuneo TakenakaTakahiro Amano
Mar 18, 2021·Zeitschrift für Gastroenterologie·Florian Gunnar ScurtChristos Chatzikyrkou
May 25, 2021·World Journal of Gastroenterology : WJG·Roman MaslennikovElena Shirokova

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