Membranous nephropathy associated with hepatitis B in Spanish children

Aim: To examine retrospectively long-term evolution and treatment of pediat ric membranous nephropathy (MN) cases associated with hepatitis B (HB) in t he hospital "La Paz". Material and methods: The clinical records of 12 chil dren diagnosed with HB-associated MN in our hospital between 1970 and 1996. Results: All patients were positive for hepatitis B surface antigen (HBsAg ); 6 were tested for hepatitis Be antigen (HBeAg) and were also positive. A t onset, all of them had proteinuria (8 in nephrotic range), 6 had microsco pic hematuria and 4 macroscopic hematuria. Seven of 8 children who started with a nephrotic syndrome received steroids and all of them were steroid-re sistant. After 9.95 +/- 5.88 years of follow-up, renal function remained no rmal and proteinuria and hematuria have disappeared in all of them. A famil y study for hepatitis B was carried out in 8 cases and 7 of them were posit ive. Only in one case vertical transmission was demonstrated; this patient remained HBeAg positive. In 7 patients, hepatic biopsy was performed: 3 had a chronic active hepatitis, 3 a persistent chronic hepatitis and one a res idual acute hepatitis. Conclusions: Membranous nephropathy is a rare pediat ric disease in our area and most of the cases are related to hepatitis B (H B). The outcome was excellent with and without treatment but all of them re mained HBsAg positive.