Karyomegalic interstitial nephritis as a rare cause of kidney graft dysfunction: case report and review of literature.

Karyomegalic interstitial nephritis (KIN) is a rare cause of chronic interstitial nephritis characterized by enlarged renal tubular epithelial nuclei. The first case of KIN reported in a kidney graft was in 2019. Here, we report the first case of KIN in 2 brothers receiving kidneys from 2 different unrelated living donors. A male kidney transplant recipient with focal segmental glomerulosclerosis as the original kidney disease presented with graft impairment and proteinuria, and graft biopsy revealed KIN. This patient had a brother who was also a kidney transplant recipient and had one episode of graft impairment and was diagnosed with KIN as well.

Sofosbuvir and Daclatsvir in Treatment of Hepatitis C Virus-related Membranoproliferative Glomerulonephritis With Cryoglobulinemia in a Patient With Hepatitis C Genotype 4.

Direct antivirals showed dramatic response in hepatitis C virus (HCV) eradication, but their effect on extrahepatic manifestations is still unclear. A 49-year-old woman was referred to us suffering from lower limb edema and frothy urine. Renal biopsy was done and she was diagnosed with HCV-related membranoproliferative glomerulonephritis with cryoglobulinemia. Treatment with interferon plus ribavirin, steroid, and cyclophosphamide was tried but failed. After introduction of a sofosbuvir-based regimen to the treatment, sustained virologic response was achieved and nephrotic syndrome remission was induced successfully. We could conclude that HCV-related membranoproliferative glomerulonephritis with cryoglobulinemia could be treated successfully with immunosuppressive drugs plus sofosbuvir and dacalatasvir.