S-Space College of Medicine/School of Medicine (의과대학/대학원) Dept. of Medicine (의학과) The Seoul Journal of Medicine The Seoul Journal of Medicine Vol. 27 No.2 (1986)
Effect of Hepatitis B Virus Infection of Membranous Nephropathy
HBV항원 및 항체유무에 따른 막성사구체신염(膜性絲毬體腎炎)의 임상 및 병리학적 소견의 비교연구
- Lee, Jung Sang; Ahn, Curie; Han, Jin Suk; Kim, Suhnggwan; Kim, Yong Il
- Issue Date
- Seoul J Med, Vol.27 No.2, pp. 155-167
- To elucidate the effect of HBsAg on MN, 107 cases of MN admitted to SNUH
from 1979 Jan. to 1985 Dec. were evaluated according to the markers of HBV.
Positive rate of HBsAg in MN was 48% which was higher than normal population and
primary GN. Males were affected 4 times greater than females. MN with HBs antigenemia
differed from MN without the antigen by having a lower incidence of nephrotic syndrome and
azotemia. Serologically, positive rate of rheumatoid factor, ANA and rate of C4 decrement was
higher in HBsAg positive patients, indicating the active participation of immune responses.
Light microscopy demonstrated MPGN III -like lesions showing subendothelial deposit and
double contour with mesangial hypercellularity, segmental change, tubular atrophy and interstitial
fibrosis. Immunofluorescent microscopy showed frequent deposits of IgA and IgM in
HBsAg positive group, and HBsAg, HBcAg were demonstrated in 76.9% and 31.4% of them.
Although the exact pathogenesis is not clear, the participation of multiple antigen and antibody
system including HBsAg and HBcAg was clear, as well as the participation of hepatic
dysfunction caused by liver cirrhosis on immune complex of rheumatoid factor, IgA deposit,
subendothelial deposit have been proved to meet a concerted effect in the characterization of
HBsAg related MN showing lupus-like features.