Korean J Med.  2002 Aug;63(2):126-133.

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

• An WS
• Kim KH

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 6:0 in MPGN III, 6:2 in MN, 17:2 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.

Keyword

Hepatitis B virus associated membranous nephropathy; Membranoproliferative glomerulonephritis type I; Membranoproliferative glomerulonephritis type III

MeSH Terms

Alanine Transaminase
Antigens, Surface
Aspartate Aminotransferases
Glomerulonephritis, Membranoproliferative*
Glomerulonephritis, Membranous
Hepatitis B Surface Antigens*
Hepatitis B virus
Hepatitis B, Chronic
Humans
Male
Proteinuria
Retrospective Studies
Alanine Transaminase
Antigens, Surface
Aspartate Aminotransferases
Hepatitis B Surface Antigens