Chronic hepatitis B triggering antineutrophil cytoplasmic antibodyassociated vasculitis complicated by glomerulonephritis:A case report  

作　　者：Ming-Ru Li Li-Ya Li Juan Tang Jian Sun 

机构地区：[1]Department of Nephrology and Rheumatology,The Third Xiangya Hospital,Central South University,Changsha 410013,Hunan Province,China [2]Department of Rheumatology and Immunology,Xiangya Hospital of Central South University,Changsha 410013,Hunan Province,China [3]Department of Nephrology,Central South University,Changsha 410013,Hunan Province,China

出　　处：《World Journal of Clinical Cases》2025年第19期43-51,共9页世界临床病例杂志(英文)

基　　金：Supported by the Natural Science Foundation of Hunan Province,China,No.2023JJ30842.

摘　　要：BACKGROUND Hepatitis B virus(HBV)infection can lead to renal involvement,commonly manifested as HBV-associated glomerulonephritis(HBV-GN),which typically presents as nephrotic or nephritic syndrome.Antineutrophil cytoplasmic antibody-associated vasculitis(AAV)is a systemic disease characterized by immune necrotizing inflammation of small blood vessels involving multiple organs with complex and severe clinical implications.The coexistence of HBV-GN and AAV is sporadic,with limited data existing regarding its diagnosis,management,clinical outcomes,and prognosis,especially in patients with AAV.CASE SUMMARY This manuscript presents the case of an older male patient who presented with persistent foamy urine lasting over two weeks.Initial clinical findings included nephrotic syndrome and renal insufficiency,which subsequently progressed to involve the lungs,immune system,hematologic system,and other organ systems.The patient was diagnosed with HBV-GN complicated by AAV,a rare and complex condition.Despite receiving comprehensive treatment,including corticosteroids,cyclophosphamide for immune regulation,plasma exchange,and immunoadsorption targeting antineutrophil cytoplasmic antibody-associated antibodies,the patient required long-term dialysis and demonstrated a poor prognosis.CONCLUSION HBV infection may trigger nephropathy with AAV.Early recognition and intervention are crucial for improving patient prognosis.

关 键 词：Hepatitis B virus Antineutrophil cytoplasmic antibody-associated vasculitis NEPHROPATHY Complications Immune complex Alveolar hemorrhage Plasma exchange Protein A immunoadsorption Case report 

分 类 号：R51[医药卫生—内科学]