First published online: 01 Dec 2012
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J Renal Inj Prev. 2012;1(1).
doi: 10.12861/jrip.2012.14
PMID: 25340103
PMCID: PMC4205971
  Abstract View: 1507
  PDF Download: 960

Renal Biopsy Teaching Point

Sudden deterioration of renal function in a patient with nephrotic syndrome and a very high hepatitis B viral DNA load

Hamid Nasri 1, Muhammed Mubarak 2 *

1 Department of Nephrology, Division of Nephropathology, Isfahan University of Medical Sciences, Isfahan, Iran
2 Department of Histopathology, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan
*Corresponding author: Muhammed Mubarak, Department of Histopathology, Sindh Institute of Urology and Transplantation (SIUT), Karachi, Pakistan. Email: drmubaraksiut@yahoo.com

Article

Implication for health policy/practice/research/medical education:In this case, the clinical history and morphologic lesions of kidney biopsy of a 38 year-old Afghan origin male are discussed. The patient presented with nephrotic syndrome and positive hepatitis B surface antigen (HBsAg). Renal biopsy was mostly consistent with membranoproliferative glomerulonephritis (MPGN) type I. Two months after prednisolone therapy, patient’s condition suddenly deteriorated and acute renal failure was found. The patient underwent dialysis. During evaluation, >2×107 IU/ml of viral DNA of hepatitis B was found. In the second biopsy, crescentic glomerulonephritis was evident. After adding lamivudine to the regimen, serum creatinine decreased and stabilized at 1 mg/dl. Patient was discharged in stable condition and the lamivudine was continued.
Please cite this paper as: Nasri H, Mubarak M. Sudden deterioration of renal function in a patient with nephrotic syndrome and a very high hepatitis B viral DNA load. J Ren Inj Prev 2012; 1(1): 39-41.
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