The clinical findings of membranoproliferative glomerulonephritis type III in patients with positive serum HBsAg / 대한내과학회지

ABSTRACT

BACKGROUND: It is well known that chronic hepatitis B virus infection can commonly cause membranous nephropathy (MN), membranoproliferative glomerulonephritis type I (MPGN I), and rarely, membranoproliferative glomerulonephritis type III (MPGN III), which has the combined pathologic findings of MN and MPGN I. We report the clinical findings of MPGN III in patients with positive serum hepatitis B virus surface antigen. METHODS: The clinical findings of six MPGN III patients were investigated retrospectively to compare with those of eight MN and nineteen MPGN I patients with positive serum hepatitis B virus antigen. RESULTS: The mean age of MPGN III cases (29.7 years) was younger than that of MN (43.7 years) and MPGN I cases (44.4 years)(p<0.05). Males were predominant in all groups and the male/female ratio was 60 in MPGN III, 62 in MN, 172 in MPGN I group. The cases of nephrotic range proteinuria (4 out of 6 (66.7%) in MPGN III and 6 out of 8 (75%) in MN group) were more frequent than the 5 out of 19 (26.3%) found in the MPGN I group (p<0.05). The cases of HBe antigenemia were 5 out of 6 (83.3%) in MPGN III, 16 out of 19 (84.2%) in MPGN I and 5 out of 8 (62.5%) in the MN group. The cases of increased SGOT level were 5 out of 6 (83.3%) in MPGN III, 14 out of 19 (73.7%) in MPGN I and 4 out of 8 (50%) in the MN group. The cases of increased SGPT level were 5 out of 6 (83.3%) in MPGN III, 10 out of 19 (52.6%) in MPGN I and 2 out of 8 (25%) in the MN group. The cases of decreased serum C3 level were 4 out of 6 (66.7%) in MPGN III, 13 out of 19 (68.4%) in MPGN I and 3 out of 8 (37.5%) in the MN group. CONCLUSION: Patients with MPGN III show similar clinical findings to both the nephrotic proteinuria of MN patients and the decreased serum C3 level and increased SGOT/SGPT of MPGN I patients.