Immune mediated crescentic MPGN secondary to HBV infection: A rare presentation for a common infection

Aswani Srinivas Mareddy; Dharshan Rangaswamy; Mahesha Vankalakunti; Ravindra Prabhu Attur; Shankar Prasad Nagaraju; Neeraja Koti

doi:10.4066/AMJ.2015.2568

Immune mediated crescentic MPGN secondary to HBV infection: A rare presentation for a common infection

Australas Med J. 2016 Jan 31;9(1):12-6. doi: 10.4066/AMJ.2015.2568. eCollection 2016.

Authors

Aswani Srinivas Mareddy¹, Dharshan Rangaswamy¹, Mahesha Vankalakunti², Ravindra Prabhu Attur¹, Shankar Prasad Nagaraju¹, Neeraja Koti³

Affiliations

¹ Department of Nephrology, Kasturba Medical College, Manipal University, Mangalore, India.
² Department of Pathology and Lab Medicine, Manipal Hospitals, Bengaluru, India.
³ Department of Medicine, Kasturba Medical College, Manipal University, Mangalore, India.

Abstract

Hepatitis B virus (HBV) infection presenting as crescentic glomerulonephritis in the absence of cryoglobulinemia is an extremely rare phenomenon. We report a case of a 44-year-old male with HBV infection, who underwent kidney biopsy for rapidly progressive renal failure and nephrotic range proteinuria. Histopathological evaluation of the kidney biopsy was consistent with immune complex mediated crescentic membranoproliferative glomerulonephritis (MPGN). The patient achieved complete renal and virological remission with steroids, plasmapheresis and antiviral therapy. This case report summarises the importance of early initiation of immunosuppression and plasmapheresis under antiviral coverage for improved clinical outcomes.

Keywords: Hepatitis B Virus; MPGN; crescentic glomerulonephritis; crescentic membranoproliferative glomerulonephritis.

Publication types

Case Reports