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Effectiveness of treatment of cryoglobulinemic glomerulonephritis with rituximab and plasmapheresis after obtaining a sustained response to interferon-free antiviral therapy in chronic hepatitis C


- Oddział Kliniczny Nefrologii, Diabetologii i Chorób Wewnętrznych Wojewódzki Szpital Zespolony im. L. Rydygiera, Św. Józefa 53–59, 87–100 Toruń, Poland
- Oddział Hepatologiczny, Wojewódzki Szpital Zespolony w Toruniu
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Abstract
Contemporary treatment of chronic hepatitis C lasts long, it is difficult and very expensive. Introduction of new antiviral drugs has significantly improved outcomes of the therapy, including patients with deteriorated kidney function. A part of the individuals with HCV infection may develop glomerulonephritis and nephrotic syndrome. Mixed cryoglobulinemia type II, which is found in almost half of the patients with hepatitis C, can be an independent factor leading to kidney injury. We present the case of 39 years old female, who developed nephrotic syndrome and kidney failure in the course of cryoglobulinemic glomerulopathy, after completing antiviral interferon-free therapy. There was introduced associated treatment of steroids, rituximab and plasma exchange, which appeared to be successful.
Abstract
Contemporary treatment of chronic hepatitis C lasts long, it is difficult and very expensive. Introduction of new antiviral drugs has significantly improved outcomes of the therapy, including patients with deteriorated kidney function. A part of the individuals with HCV infection may develop glomerulonephritis and nephrotic syndrome. Mixed cryoglobulinemia type II, which is found in almost half of the patients with hepatitis C, can be an independent factor leading to kidney injury. We present the case of 39 years old female, who developed nephrotic syndrome and kidney failure in the course of cryoglobulinemic glomerulopathy, after completing antiviral interferon-free therapy. There was introduced associated treatment of steroids, rituximab and plasma exchange, which appeared to be successful.
Keywords
membranoproliferative glomerulonephritis; cryoglobulin; rituximab; plasmapheresis; interferon-free therapy; HCV infection


Title
Effectiveness of treatment of cryoglobulinemic glomerulonephritis with rituximab and plasmapheresis after obtaining a sustained response to interferon-free antiviral therapy in chronic hepatitis C
Journal
Renal Disease and Transplantation Forum
Issue
Pages
186-190
Page views
666
Article views/downloads
1596
Bibliographic record
Forum Nefrologiczne 2017;10(3):186-190.
Keywords
membranoproliferative glomerulonephritis
cryoglobulin
rituximab
plasmapheresis
interferon-free therapy
HCV infection
Authors
Marek Muszytowski
Joanna Zawadzka
Anna Badurek
Leszek Jułga