Exacerbation of glomerulonephritis

in subjects with chronic hepatitis C

virus infection after interferon
therapy

Submitted by:
Rafael Joseph P. Lardizabal
BSN 3-NCB2
Surgery ward 3-11pm
March 19-21/26-28, 2020

Submitted to:
Ma’am Charmaine Paloga RN, MAN
B. SUMMARY OF THE JOURNAL

This journal talks about glomerular deposition of hepatitis C virus (HVC), core

antigen (AG), in HCV related nephropathy. The researchers of this study analyzed 23

HCV-positive patients that have exacerbations of proteinuria/ hematuria during

interferon (IFN) therapy, they also measured that urinary protein selectivity. The

researchers also examined the involvement of HCV-related AG by using the anti HCV

core (capside) Ag murine monoclonal antibody (Ab) and anti-core2 rabbit polyclonal Abs

in nine patients.

They used 17 patients, the 13 (78%) showed that they have low selective

proteinuria. In the 9 patients, they found mesangial proliferative glomerulonephritis and

in 1 patient, they found him/her to have membranoproliferative glomerulonephritis and in

1 patient, with nephrosclerosis. In the results, Immunofluorescence study showed the

glomerular deposition of immunoglobulin G (igG) or IgA and complements in all 9

patiens that are examined. In 3 out of 9 patients (33%) the HCV core Ag was detected

along with glomerular capillary

The researchers used electron microscopy that showed subendothelial or

mesangial electron-dense deposits and also foot process effacement (20%-72.5 of

glomerular capillary walls) in all patients and endothelial swelling in 4.

In conclusion, Glomerulonephritis may be exacerbated by IFN therapy, unrelated

to HCV Ags. Through direct or indirect effects on glomerular endothelial and epithelial

cells. Physicians should carefully distinguish HCV-related nephropathy from other

glomerular diseases when they administer IFN therapy to HCV-positive subjects.

C. REACTION:

Insights:
I learned that IFN therapy exacerbates glomerulonephritis. Out of the 17

patients they examined, most of them experience exacerbations, while glomerular

deposition of immunoglobulin G (igG) or IgA and complements in all 9 patients, Iin 3 out

of 9 patients (33%) the HCV core Ag was detected along with glomerular capillary, 1

patient, they found him/her to have membranoproliferative glomerulonephritis and in 1

patient, with nephrosclerosis.

RELEVANCE TO AREA OF ROTATION:

The relevance of this study to the surgery ward is that with these results of

each patient, the doctors and medical staff will learn surgical and medical managements

for the next patients to have these problems.

RELEVANCE TO P, E R

The relevance of this to our practice is that it can help us know what to do,

how to deal, therapeutically and how to handle patients with these kinds of problems

and that for us to be aware that patients with these problems are growing so we have to

be ready for them.

The relevance of this to our education is that it teaches us more stuff

about glomerulonephritis that it has many complications, many more problems and HCV

is a major problem when having glomerulonephritis.

The relevance of this to research is that it helps the researchers to fully

understand much more about glomerulonephritis and HCV and help this research grow

so that it is much more clearer and easier to understand when this certain disease or

problem arises in the future.

D. LEARNING INSIGHTS TO JOURNAL

I learned in this journal that there are multiple types of exacerbations that

happen in glomerulonephritis, that there are different reasons why glomerulonephritis

happens, that there are multiple problems associated to glomerulonephritis and that

there are a lot of complications, diseases that are related to glomerulonephritis.

I also learned that though they only got 23 patients, it is still a major

problem when having these diseases with glomerulonephritis. I also learned that

exacerbations can happen with glomerulonephritis with HCV and that this type of

disease can be checked or diagnosed with Immunofluorescence study.

E. REFERENCES

https://www.sciencedirect.com/science/article/abs/pii/S027263869970140X