A nephropathy presenting the microparticles in the glomerular basement membrane in a patient of hepatitis B viral infection

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http://www.springerlink.com/content/213g57152087h078/

A nephropathy presenting the microparticles in the glomerular basement membrane

in a patient of hepatitis B viral infection

Journal Clinical and Experimental Nephrology

Publisher Springer Japan

ISSN 1342-1751 (Print) 1437-7799 (Online)

Category Case Report

DOI 10.1007/s10157-008-0087-9

Subject Collection Medicine

SpringerLink Date Wednesday, October 15, 2008

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Case Report

Special issue Podocytic infolding glomerulopathy: a proposed new disease entity

A nephropathy presenting the microparticles in the glomerular basement membrane

in a patient of hepatitis B viral infection

Shinichi Nishi1 , Naofumi Imai3, Takao Saito3, Mitsuhiro Ueno3, Masaaki

Arakawa3, Takashi Oota2 and Fumitake Gejyo3

(1) Blood Purification Center, Niigata University Medical and Dental Hospital,

1-754 Asahimachi-dori, Chuo-ku, Niigata 951-8520, Japan

(2) Division of Internal Medicine, Kido Hospital, Niigata, Japan

(3) Division of Clinical Nephrology and Rheumatology, Graduate School of

Medical and Dental Sciences, Niigata University, Niigata, Japan

Received: 17 June 2008 Accepted: 26 August 2008 Published online: 15 October

2008

Abstract We report here unique electron microscopy findings showing clusters of

deposition of spherical and tubular microparticles in a glomerular basement

membrane (GBM) of a 46-year-old Japanese male with membranous nephropathy.

Another distinct feature was the deep infolding of podocyte membranes into the

GBM. Light microscopy showed the ladder formation of the GBM suggesting

membranous nephropathy, while the immunofluorescent examination was atypical for

the absence of the global capillary deposition of IgG and C3. He had mild liver

dysfunction with positive hepatitis B antigen. Antibodies to hepatitis B surface

antigen reacted weakly on the GBM in the immunohistochemistry. We suspected the

unique findings of this case might be related to the hepatitis B viral

infection.

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Shinichi Nishi

Email: snishi@...