Hepatitis E virus infection as a new probable cause of de novo membranous nephropathy after kidney transplantation.

Abstract

Hepatitis E virus (HEV) has been identified as a cause of chronic viral hepatitis in immunocompromised patients. Some glomerular diseases were found to be associated with this infection. We report the first case, to our knowledge, of a kidney transplant recipient who developed an HEV infection and de novo membranous nephropathy (MN) concomitantly. The patient displayed a hepatic cytolysis first and a nephrotic syndrome occurred 3 months later. HEV infection was diagnosed upon positive polymerase chain reaction on plasma and stool samples, and renal allograft biopsy revealed de novo MN. Typical causes of MN were definitively excluded. A 3-month course of ribavirin monotherapy allowed the patient to mount a sustained viral response that was rapidly followed by complete remission of the nephrotic syndrome. The chronology of the onset and remission of both diseases is highly suggestive of a causal relationship between hepatitis E and MN.

• Authors: B Taton, K Moreau, S Lepreux, T Bachelet, P Trimoulet, V De Ledinghen, A Pommereau, P Ronco, N Kamar, P Merville, L Couzi
• Journal: Transplant infectious disease : an official journal of the Transplantation Society (Transpl Infect Dis) Vol. 15 Issue 6 Pg. E211-5 (Dec 2013) ISSN: 1399-3062 [Electronic] Denmark
• PMID: 24103101 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Topics

• Glomerulonephritis, Membranous (virology)
• Hepatitis E (complications, drug therapy)
• Humans
• Kidney Transplantation
• Male
• Middle Aged