caa a22 4500 445883839 CHVBK 20180317145553.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1007/s10157-010-0391-z doi (NATIONALLICENCE)springer-10.1007/s10157-010-0391-z Steroid treatment in patients with membranous nephropathy and hepatitisB virus surface antigenemia: a report of two cases [Elektronische Daten] [Tetsu Akimoto, Toshiya Otake, Akira Tanaka, Hideaki Takahashi, Toshihiko Higashizawa, Makoto Inoue, Katsuhiko Nishino, Osamu Saito, Norio Isoda, Shigeaki Muto, Kentaro Sugano, Eiji Kusano] Although the clinical benefits of antiviral treatment in the management of membranous nephropathy (MN) in patients with chronic hepatitisB virus (HBV) infection have been suggested, it should be evaluated more carefully. In this report, we present two cases with quiescent HBV who were administered lamivudine for either the initial treatment of MN or to control the reactivation of HBV during treatment with corticosteroids. No clinical benefit of lamivudine as an initial treatment was observed in one patient, which obliged us to commence administration of prednisolone (PSL). On the other hand, lamivudine seemed to play a pivotal role in the remission of an acute exacerbation of hepatitisB during treatment with PSL and mizoribine in the other patient. These two patients seemed to tolerate administration of PSL with or without an immunosuppressive agent well, since gradual and prompt improvements of nephrotic status were confirmed within a few months, thus suggesting the potential benefit of steroid treatment. There is little consensus regarding the optimal choice of steroids and immunosuppressants for the treatment of MN with chronic HBV infection, due to the potential for stimulation of viral replication and precipitation of hepatic flares. Our observations, however, suggest that treatment with PSL still should be reserved for quiescent HBV carriers with MN. Further studies will be required to determine the optimal timing and appropriate duration of antiviral treatment in such patients requiring long-term immunosuppression. Japanese Society of Nephrology, 2010 Membranous nephropathy nationallicence Lamivudine nationallicence HepatitisB virus reactivation nationallicence Nephrotic syndrome nationallicence Corticosteroid nationallicence Akimoto Tetsu Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut Otake Toshiya Division of Gastroenterology, Department of Internal Medicine, Jichi Medical University, 329-0498, Shimotsuke, Tochigi, Japan aut Tanaka Akira Department of Diagnostic Pathology, Jichi Medical University, 329-0498, Shimotsuke, Tochigi, Japan aut Takahashi Hideaki Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut Higashizawa Toshihiko Division of Gastroenterology, Department of Internal Medicine, Jichi Medical University, 329-0498, Shimotsuke, Tochigi, Japan aut Inoue Makoto Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut Nishino Katsuhiko Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut Saito Osamu Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut Isoda Norio Division of Gastroenterology, Department of Internal Medicine, Jichi Medical University, 329-0498, Shimotsuke, Tochigi, Japan aut Muto Shigeaki Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut Sugano Kentaro Division of Gastroenterology, Department of Internal Medicine, Jichi Medical University, 329-0498, Shimotsuke, Tochigi, Japan aut Kusano Eiji Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut Clinical and Experimental Nephrology Springer Japan 15/2(2011-04-01), 289-293 1342-1751 15:2<289 2011 15 10157 https://doi.org/10.1007/s10157-010-0391-z text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10157-010-0391-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Akimoto Tetsu Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Otake Toshiya Division of Gastroenterology, Department of Internal Medicine, Jichi Medical University, 329-0498, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Tanaka Akira Department of Diagnostic Pathology, Jichi Medical University, 329-0498, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Takahashi Hideaki Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Higashizawa Toshihiko Division of Gastroenterology, Department of Internal Medicine, Jichi Medical University, 329-0498, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Inoue Makoto Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Nishino Katsuhiko Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Saito Osamu Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Isoda Norio Division of Gastroenterology, Department of Internal Medicine, Jichi Medical University, 329-0498, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Muto Shigeaki Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Sugano Kentaro Division of Gastroenterology, Department of Internal Medicine, Jichi Medical University, 329-0498, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 700 1- Kusano Eiji Division of Nephrology, Department of Internal Medicine, Jichi Medical University, 3311-1 Yakushiji, 329-0498, Shimotsuke, Tochigi, Japan aut NATIONALLICENCE 773 0- Clinical and Experimental Nephrology Springer Japan 15/2(2011-04-01), 289-293 1342-1751 15:2<289 2011 15 10157 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer