Complete remission of cryoglobulinemic glomerulonephritis (HCV-positive) after high dose interferon therapy. 2000

M Laganović, and B Jelaković, and D Kuzmanić, and M Sćukanec-Spoljar, and T Roncević, and S Cuzić, and R Ostojić
Department of Internal Medicine, University Hospital Center Zagreb, Croatia. mario.laganovic@zg.tel.hr

We report the case of a 64-year old woman with hepatitis C virus infection, mixed cryoglobulinemia type II (IgG + IgM kappa) and cryoglobulinemic glomerulonephritis. The patient was treated with the standard dose of recombinant interferon alpha-2b (3 million units 3 times a week) for one year, resulting in complete clinical remission and undetectable levels of serum hepatitis C virus RNA. AST and ALT normalized and proteinuria decreased from 2.78 to 0.98 g/day. However, a relapse occurred when therapy was stopped. Additional therapy with interferon-alpha (5 million units 3 times a week for 9 months) resulted again in quick and prolonged remission. The clinical course of our patient showed sustained clinical and virologic response after high-dose interferon-alpha treatment confirming the usefulness of interferon alpha in treatment of patients with cryoglobulinemic glomerulonephritis. Our observation is in agreement with others, suggesting that recommended standard dosage and duration of initial treatment with interferon alpha should be re-evaluated. Although our patient had sustained virologic and clinical response after interferon alpha monotherapy, recent studies clearly support combination therapy of interferon alpha and ribavirin for treatment of chronic HCV infections.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011994 Recombinant Proteins Proteins prepared by recombinant DNA technology. Biosynthetic Protein,Biosynthetic Proteins,DNA Recombinant Proteins,Recombinant Protein,Proteins, Biosynthetic,Proteins, Recombinant DNA,DNA Proteins, Recombinant,Protein, Biosynthetic,Protein, Recombinant,Proteins, DNA Recombinant,Proteins, Recombinant,Recombinant DNA Proteins,Recombinant Proteins, DNA
D012008 Recurrence The return of a sign, symptom, or disease after a remission. Recrudescence,Relapse,Recrudescences,Recurrences,Relapses
D003449 Cryoglobulinemia A condition characterized by the presence of abnormal quantities of CRYOGLOBULINS in the blood. Upon cold exposure, these abnormal proteins precipitate into the microvasculature leading to restricted blood flow in the exposed areas. Cryoglobulinemias
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D004305 Dose-Response Relationship, Drug The relationship between the dose of an administered drug and the response of the organism to the drug. Dose Response Relationship, Drug,Dose-Response Relationships, Drug,Drug Dose-Response Relationship,Drug Dose-Response Relationships,Relationship, Drug Dose-Response,Relationships, Drug Dose-Response
D005260 Female Females
D005921 Glomerulonephritis Inflammation of the renal glomeruli (KIDNEY GLOMERULUS) that can be classified by the type of glomerular injuries including antibody deposition, complement activation, cellular proliferation, and glomerulosclerosis. These structural and functional abnormalities usually lead to HEMATURIA; PROTEINURIA; HYPERTENSION; and RENAL INSUFFICIENCY. Bright Disease,Kidney Scarring,Glomerulonephritides,Scarring, Kidney
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000077190 Interferon alpha-2 Alpha interferon encoded by the human IFNA2 gene. Recombinant forms are used in the treatment of CHRONIC HEPATITIS B; CHRONIC HEPATITIS C; KAPOSI SARCOMA; MELANOMA; and HAIRY CELL LEUKEMIA. IFN-alpha 2,IFN-alpha-2,IFNalpha-2b, Recombinant,Interferon alfa-2a,Interferon alfa-2b,Interferon alpha-2b, Recombinant,Interferon alpha-A,Interferon-alpha 2,Intron A (Interferon),LeIF A,Reaferon,Recombinant Interferon alpha-2a,Recombinant Interferon alpha-2b,Ro 22-8181,Roferon-A,Sch-30500,Viferon,IFNalpha 2b, Recombinant,Interferon alfa 2a,Interferon alfa 2b,Interferon alpha 2,Interferon alpha 2b, Recombinant,Interferon alpha A,Interferon alpha-2a, Recombinant,Recombinant IFNalpha-2b,Recombinant Interferon alpha 2a,Recombinant Interferon alpha 2b,Ro 22 8181,Ro 228181,Roferon A,RoferonA,Sch 30500,Sch30500

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