Abstract
Hepatitis C viral infection occurs relatively low in Korea compared to hepatitis
B. However, it progresses into chronic hepatitis and cirrhosis more frequently
than HBV. It may be associated with cryoglobulinemia and glomerulonephritis,
both in native and transplanted kidneys. We report three cases of
membrano-proliferative glomerulonephritis type I in anti-HCV positive, but
cryoglobulin-negative patients, presenting massive proteinuria, two in native
kidneys and one in an allograft. HCV-RNA was positive in sera of two patients.
Two were cirrhotic and ALT was mildly elevated in two. In addition to the
characteristic membranoproliferative feature, two native kidneys overlapped with
features of diabetic nephropathy. Immunofluorescence demonstrated mainly IgM and
C3 deposits along the peripheral capillary walls. Subendothelial electron dense
deposits were present in the glomeruli of all three cases with subepithelial and
intramembranous deposits in two. HCV-RNA was associated not only with a greater
amount of immune deposits but also with subepithelial and intramembranous
deposits, indicating the role of active infection.