1984 Volume 26 Issue 8 Pages 1079-1089
The purpose of this study is to clarify clinical, histological and immunological characteristics of glomerulonephritis associated with hepatitis B virus infection (HB nephritis) in adult patients, using lupus nephritis and glomerulonephritis associated with non-HB virus liver disease (non HB nephritis with liver disease) as controls. We selected 40 adult cases of HB nephritis, the sex ratio being 3 males to one female, As control groups we selected 80 cases of lupus nephritis and 12 cases of non HB nephritis with liver disease. Out of 40 patients with HB nephritis, 38 had proteinuria, 27 hematuria and 6 high serum creatinine level (Creatinine≥2 .0 mg/dl). The histological grades of their glomerular lesions were 6 cases of minimal changes, 23 of proliferative GN, 5 of membranous GN, and 6 of MPGN type III. Ultrastructurally, 16 out of 38 patients with HB nephritis were shown to have had multiple dense deposits which appeared in mesangial matrix, subepithelium and/or subendothelium. Only 3 cases were limited in subepithelial deposit. We concluded that most of the adult patients with HB nephritis histologically show mesangial proliferative GN with dense deposit in various sites, in contrast to child HB nephritis. MPGN type III accounts for 15% in adult patients with HB nephritis, which is the highest incidence in comparison with the control groups. Mode of dense deposits of HB nephritis ultrastructurally are characteristic and are differed from control groups. HB nephritis with active liver disease, histologically, shows more severe glomerular damage and poorer prognosis than HB nephritis with non-active liver disease.
