만성 B형간염과 신장질환의 조직학적 상관관계

Abstract

Background / Aims : The relationship between HBV infection and nephropathy has been reported with some differences according to the investigators and regions studied. Liver biopsis were not performed in most of the reports. In this study both liver and kidney biopsis were performed. The histologic correlation was analyzed between chronic B viral hepatitis and nephropathy. Methods : From January 1985 ro june and hebaturia. Also, a new histopathologic calssification of chronic hepatitis was applied in the assessment of liver disease. Results : Light microscopy of kidneys showed IgA nephropathy in 7 cases(27%) ; minimal change nephrotic syndrome(MCNS) in 1 case (3.8%); and membranous glomerulonephritis(MGN) in 9 cases(34.6%), membranoproliferative glomerulonephritis (MPGN) in 9 cases (34.6%). Among the cases with a higher hepatitis activity index and fibrosis score, the frequency of MGN and MPGN was higher. The hepatitis activity index of cases with MGN was significantly higher than IgA nephropathy and MPGN (p=0.011, p=0.039). The fibrosis score of cases with MGN and MPGN was significantly higher than IgA nephropathy (p=0.011, p=0.003). The positivity of HBeAg was highest in cases with MGN.Serum C3 level was low in all cases but the serum C4 level was within normal range. Immunofluorescence studies showed granular deposition of Ig G and C3 in the capillary loops in MGN. Conclusion : The frequency of MGN and MPGN was higher when the liver disease was more severe. It was suggested that HBeAg, IgG AND C3 might ci\ontribute to the pathogenesis of MGN in HBsAg positive patients.