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CEN Case Rep. 2015 May;4(1):38-42. doi: 10.1007/s13730-014-0136-z. Epub 2014 Jul 15.

Hepatitis C virus-related glomerulonephritis with acute kidney injury requiring hemodialysis that improved with virus removal and eradication using double-filtration plasmapheresis without interferon.

CEN case reports

Akiko Morisue, Kosuke Fukuoka, Ruiko Goto, Kosuke Ota, Haruhiro Yamashita, Yoko Shinno, Ichiro Yamadori

Affiliations

  1. Department of Nephrology, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Okayama, 701-1192, Japan.
  2. Department of Nephrology, National Hospital Organization Okayama Medical Center, 1711-1 Tamasu, Okayama, 701-1192, Japan. [email protected].
  3. Department of Gastroenterology, National Hospital Organization Okayama Medical Center, Okayama, Japan.
  4. Department of Pathology, National Hospital Organization Okayama Medical Center, Okayama, Japan.

PMID: 28509265 PMCID: PMC5413711 DOI: 10.1007/s13730-014-0136-z

Abstract

A 66-year-old, hepatitis C virus (HCV)-positive woman was admitted to our hospital with oliguria, systemic edema, and rapid deterioration of renal function. Laboratory examination showed increased serum creatinine and decreased serum albumin levels, complement activity, and cryoglobulin positivity. The HCV RNA genotype was found to be 1b, and the viral load was high. Kidney biopsy examination showed type I membranoproliferative glomerulonephritis with capillary deposition of IgM and C3, indicating HCV-related glomerulonephritis. After hospitalization, hemodialysis was immediately required because of uremia and oliguria. Her renal function did not improve despite corticosteroid therapy. To treat the increasing HCV load, virus removal and eradication by double-filtration plasmapheresis therapy without interferon was performed, since the patient was allergic to interferon therapy. This treatment improved renal function and allowed the withdrawal from hemodialysis. This report presents a case of successful VRAD without interferon therapy in a patient with HCV-related glomerulonephritis and acute kidney injury that required hemodialysis.

Keywords: HCV genotype 1b; Membranoproliferative glomerulonephritis; Virus removal and eradication by double-filtration plasmapheresis

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