Simultaneous occurrence of hepatitis C virus-associated glomerulonephritis and AL amyloidosis

Nephrol Dial Transplant. 2009 Sep;24(9):2943-5. doi: 10.1093/ndt/gfp296. Epub 2009 Jun 25.

Abstract

We report a 65-year-old male with hepatitis C virus (HCV)-associated glomerulonephritis (GN) and AL amyloidosis. This patient had a 14-year history of HCV infection with positive serum HCV RNA at presentation. Diagnosis of HCV-related GN was established using immunohistochemistry in which the HCV-NS3 antigen was mainly detected as granular deposition in glomerular mesangium. AL amyloidosis was determined by electron microscopy, positive Congo red staining and identification of lambda-chain in the kidney specimen and monoclonal IgG-lambda in serum and urine. Under immunoelectron microscopy, the HCV-NS3 antigen was found in electron-dense deposits, while lambda-chains appeared in the amyloid-like filaments.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Amyloid / metabolism
  • Amyloidosis / complications*
  • Amyloidosis / immunology
  • Amyloidosis / metabolism
  • Amyloidosis / pathology
  • Glomerulonephritis / complications*
  • Glomerulonephritis / etiology
  • Glomerulonephritis / pathology
  • Glomerulonephritis / virology
  • Hepacivirus / metabolism
  • Hepacivirus / pathogenicity
  • Hepatitis C, Chronic / complications*
  • Humans
  • Immunohistochemistry
  • Kidney / metabolism
  • Kidney / pathology
  • Kidney / virology
  • Kidney Diseases / complications*
  • Kidney Diseases / immunology
  • Kidney Diseases / metabolism
  • Kidney Diseases / pathology
  • Male
  • Microscopy, Immunoelectron
  • Viral Nonstructural Proteins / metabolism

Substances

  • Amyloid
  • NS3 protein, hepatitis C virus
  • Viral Nonstructural Proteins
  • amyloid L, human