All issues > Volume 34(11); 1991

Original Article

J Korean Pediatr Soc. 1991;34(11):1512-1518. Published online November 30, 1991.

A comparison between remission and nonremission groups of hepatitis B virus-associated membranous nephropathy in children.

Kang Yong Park¹, Hye Won Park¹, Yon Ho Choe¹, Tae Sun Ha¹, Il Soo Ha¹, Yong Choi¹, Kwang Wook Ko¹, Hyun Soon Lee², Yong Il Kim²

¹Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
²Department of Pathology, Seoul National University College of Medicine, Seoul, Korea

Received: August 31, 1991;  Accepted: October 22, 1991.

Abstract

We analyzed medical records of 35 patients with Hepatitis B virus-associated Membranous Nephropathy proven by kidney biopsy at SNUCH from Jan. 1975 to Jun. 1990. Clinical presentation, laboratory and pathologic findings were compared between remission group (who are free of proteinuria and edema in current status) and nonremission group (who have either proteinuria or edema). Age at onset was younger in remission group (4.51 ±2.93 years) than nonremission group (7.08±3.42 years). Heavy proteinuria (above 1 gm/d/m2) and decrease in serum complements (C3 and C4) were more frequent in nonremission groups. There was no difference between two groups in clinical presentations such as edema, gross hematuria, and hypertension. Also there were no difference between two groups in microscopic hematuria, increased serum creatinine, selectivity index of proteinuria, and hypercholesterolemia. Serologic negative conversion rate of Hepatitis B virus surface antigen was low in both groups and showed no difference. Serologic negative conversion rate of HBeAg was higher in remission group (81.8%) than nonremission group (25.0%). Pathologic stages were more advanced in nonremission group. There was no difference in the position of electron dense deposits. Steroid treatment had no effect on the remission of HBV-associated membranous nephropathy. In conclusion, remission group of HBV-associated MN in children seemed to have causal relation- ship with the negative conversion of HBeAg. But 2 patients of remission group had persistent HBeAg in their blood. Further study is necessary about the role of HBeAg.

Keywords :Hepatitis B virus;Membranous Nephropathy;Remission