RESUMO
Hepatitis C virus (HCV) infection affects kidneys with different histopathological patterns on kidney biopsy, which commonly include membranoproliferative glomerulonephritis (MPGN) pattern with mixed cryoglobulinemia (CG), thrombotic microangiopathy, membranous nephropathy and small to medium vessel vasculitis. Type 1 MPGN associated with type II mixed CG is the most common glomerulopathy associated with hepatitis C infection. Treatment of these glomerulopathies and cryoglobulinemic renal disease associatedwith HCV infection includes antiviral therapy for HCV, B-cell depletion therapy for prevention of immune complexes and cryoglobulins or nonspecific immunosuppressive therapy. We describe a patient who presented to us with HCV associated MPGN type 1 with cryogloblinemia and detectable HCV RNA, who recovered completely with directly acting antiviral agents (DAA) alone without immunosuppression.
RESUMO
This study was conducted to assess the presence of various types of cardiac lesions in pregnant females admitted to a tertiary care hospital of Punjab. 97 women having pregnancy and heart disease were assessed for the various etiologies, cardiac lesions, maternal and perinatal outcomes. Rheumatic heart disease (RHD) with isolated mitral stenosis was the commonest acquired lesion while mitral valve prolapse was the predominant lesion among the congenital heart disease. In the miscellaneous group, cardiomyopathy was the leading cause. Multiple cardiac lesions were diagnosed in 36 women. Majority delivered by caesarean section and some had spontaneous vaginal delivery while few required induction of labour. 19 women had cardiac complications. There were three maternal deaths.This study concluded that rheumatic heart disease in pregnancy is still predominant though acquired cardiac lesions are rising. A careful observation and management during pregnancy can improve the maternal & fetal outcomes.