Adrian Doevelaar, Bodo Hölzer, Felix Sebastian Seibert, Frederic Bauer, Ulrik Stervbo-Kristensen, Benjamin Johannes Rohn, Panagiota Zgoura, Peter Schenker, Eva Vonbrunn, Kerstin Amann, Richard Viebahn, Nina Babel, Timm Westhoff
- SARS-CoV-2 is characterized by a multiorgan tropism including the kidneys. Recent autopsy series indicated that SARS-CoV-2 can infect both tubular and glomerular cells. Whereas tubular cell infiltration may contribute to acute kidney injury, data on a potential clinical correlative to glomerular affection is rare. We describe the first case of nephrotic syndrome in the context of COVID-19 in a renal transplant recipient. A 35 year old male patient received a kidney allograft for primary focal segmental glomerulosclerosis (FSGS). Three months posttransplant a recurrence of podocytopathy was successfully managed by plasma exchange, ivIG, and a conversion from tacrolimus to belatacept (initial proteinuria > 6 g/l decreased to 169 mg/l). Six weeks later he was tested positive for SARS-CoV-2 and developed a second increase of proteinuria (5.6 g/l). Renal allograft biopsy revealed diffuse podocyte effacement and was positive for SARS-CoV-2 in RNA in-situ hybridation indicating a SARS-CoV-2 associated recurrence of podocytopathy. Noteworthy, nephrotic proteinuria resolved spontaneously after recovering from COVID-19. The present case expands the spectrum of renal involvement in COVID-19 from acute tubular injury to podocytopathy in renal transplant recipients. Thus, it may be wise to test for SARS-CoV-2 prior to initiation of immunosuppression in new onset glomerulopathy during the pandemic.
MetadatenAuthor: | Adrian DoevelaarORCiDGND, Bodo HölzerGND, Felix Sebastian SeibertORCiDGND, Frederic BauerGND, Ulrik Stervbo-KristensenORCiDGND, Benjamin Johannes RohnGND, Panagiota ZgouraGND, Peter SchenkerORCiDGND, Eva VonbrunnGND, Kerstin AmannGND, Richard ViebahnORCiDGND, Nina BabelORCiDGND, Timm WesthoffORCiDGND |
---|
URN: | urn:nbn:de:hbz:294-91115 |
---|
DOI: | https://doi.org/10.1007/s40620-020-00855-5 |
---|
Parent Title (English): | Journal of nephrology |
---|
Subtitle (English): | recurrence of nephrotic syndrome induced by SARS-CoV-2 |
---|
Publisher: | Springer |
---|
Place of publication: | Milano |
---|
Document Type: | Article |
---|
Language: | English |
---|
Date of Publication (online): | 2022/07/15 |
---|
Date of first Publication: | 2020/09/05 |
---|
Publishing Institution: | Ruhr-Universität Bochum, Universitätsbibliothek |
---|
Tag: | COVID-19; Podocytopathy; SARS-CoV-2 |
---|
Volume: | 33 |
---|
First Page: | 1369 |
---|
Last Page: | 1372 |
---|
Note: | Dieser Beitrag ist auf Grund des DEAL-Springer-Vertrages frei zugänglich. |
---|
Institutes/Facilities: | Marienhospital Herne, Medizinische Klinik I |
---|
Dewey Decimal Classification: | Technik, Medizin, angewandte Wissenschaften / Medizin, Gesundheit |
---|
open_access (DINI-Set): | open_access |
---|
Licence (English): | Creative Commons - CC BY 4.0 - Attribution 4.0 International |
---|