SUCCESSFUL TREATMENT OF NEPHROTIC SYNDROME AND SEVERE RENAL FAILURE DUE TO HEPATITIS B VIRUS RELATED DIFFUSE PROLIFERATIVE GLOMERULONEPHRITIS, WITH IMMUNSUPPRESSIVE DRUGS

Chronic hepatitis B virus (HBV) associated glomerular disease are mainly membranous glomerulonephritis, m embranoproliferative glomerulonephritis, essential mixed criyoglobulinemia, IgA nephropathy and diffuse proliferative glomerulonephritis. The pathogenesis of HBV related GN has been defined as chronic antigenemia and passive deposition of immune complex in glomeruli. We reported here a patient with liver cirrosis and proliferative GN related with HBV A fortyl-one year old man, with history of hepatitis a 20 years ago was admitted to hospital due to generalized edema. Physical examination showed that ascites, pretibial edema and diminished pulmonary sounds. Laboratory investigations were as follows: BUN 86 mg/dl, creatinin 2.2 mg/dl, total protein 5 g/dl, serum albumin 2.3 g/dl, daily proteinuria 4g. and HbsAg positive. Liver and renal biopsy showed that chirrosis, and diffuse proliferative glomerulonephritis. In this patient, nephrotic syndrome and dialysis requiring acute renal failure regressed with corticosteroid and cyclophosphamide treatment. In follow-up period after 12 months, his renal function was within normal limits and proteinuria was negative.