Analysis of clinicopathological features of hepatitis B-associated glomerulonephritis in children

Objective To investigate the clinicopathological features of hepatitis B virus-associated glomerulonephritis (HBV -GN) in children.Methods Thirty-five HBV-GN cases were confirmed by renal biopsy. Clinical and pathological features of these cases were analyzed under the light microscope,immunofluorescence and electron microscope.Results Nephrotic syndrome was the mostly encountered clinical manifestations in 35 cases, the rate of which was 91.4 %(32/35),the other was glomerulonephritis, the rate of which was 8.6 %(3/35),the most common pathological types of HBV-GN was membranous nephropathy(MN), with the rate of 94.3 %(33/35).The second was mesangial proliferative glomerulonephritis (MsPGN), with the rate of 5.7 %(2/35). Immunofluorescence microscope(IF) result showed multiple immune compound deposit; under electron microscope(EM), mesangial dense deposits could easily be found in hepatitis B virus-associated membranous nephropathy(HBV -MN) cases;2 cases of HBV-MN virus-like granules were found in the basement membrane of glomeruli.Conclusions Clinical features of children with HBV-GN are characterized by nephrotic syndrome. Pathologically ,it belongs mainly to membranous nephropathy. Emphasis on the deposit of markers of HBsAg and HBcAg in renal tissue is not needed for the diagnosis of children's HBV-MN, which is supported by the pathologic features that HBV may cause renal lesion by means of various mechanisms.