CIRRHOTIC GLOMERULONEPHRITIS - AN UNDERDIAGNOSED CONDITION

Glomerular pathology in liver cirrhosis is common in autopsies but is underdiagnosed antemortem. The most common pathologic findings are mes angial disease with immunoglobulin A deposits, and membranoproliferati ve glomerulonephritis. The latter is associated, most frequently, with hepatitis C infection and cryoglobulinemia. We describe a patient wit h longstanding liver cirrhosis who presented with a nephritic and neph rotic syndrome. Membranoproliferative glomerulonephritis was diagnosed on kidney biopsy. There was no clinical, laboratory or histologic evi dence of hepatitis C infection or cryoglobulinemia. The different aspe cts of ''cirrhotic glomerulonephritis'' are discussed and the need for searching for this underdiagnosed condition in patients with chronic liver disease is emphasized.