MEMBRANOUS GLOMERULOPATHY ASSOCIATED WITH HEPATITIS-B CORE ANTIGEN IMMUNE-COMPLEXES IN CHILDREN

  • 1 January 1980
    • journal article
    • research article
    • Vol. 98  (1) , 29-43
Abstract
Direct immunofluorescence, immunoelectron microscopy and special immunohistochemical procedures including guinea pig complement fixation, differential elution and in situ antigen (Ag) binding were employed in an immunomorphologic analysis of kidney biopsy specimens from 98 children with clinically diagnosed nephrotic syndrome and/or glomerulonephritis (GN). Glomerular deposits of hepatitis B virus (HBV) Ag, immunoglobulins and complement were detected in specimens from 24 children, all seropositive for HB surface Ag (HBsAg) and antibody to HB core Ag (HBcAg). Of these, 21 cases were diagnosed as membranous glomerulopathy (MGN), 1 as membranoproliferative GN and 2 as diffuse mesangial proliferative GN. HBcAg was identified as the only HBV Ag in about 1/3 of the cases of MGN, whereas in 1/3 it was accompanied by HBsAg. HBsAg was the only HBV antigenic component detected in the glomerular deposits in the remaining 1/3 of the cases of this GN form. HBcAg immune complexes may participate in pathogenesis of a significant number of MGN cases in children subclinically infected with HBV. These complexes may include non-particulate, presumably low MW HBcAg components. They may be formed in an environment of antibdoy excess.