COVID-19-Related Collapsing Glomerulopathy in a Kidney Transplant Recipient.
Kidney transplantation
acute kidney injury (AKI)
allograft biopsy
case report
collapsing glomerulopathy
coronavirus 2019 (COVID-19)
severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
Journal
American journal of kidney diseases : the official journal of the National Kidney Foundation
ISSN: 1523-6838
Titre abrégé: Am J Kidney Dis
Pays: United States
ID NLM: 8110075
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
28
05
2020
accepted:
30
06
2020
pubmed:
16
7
2020
medline:
21
10
2020
entrez:
16
7
2020
Statut:
ppublish
Résumé
We report a case of a kidney transplant recipient who presented with acute kidney injury and nephrotic-range proteinuria in a context of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Kidney biopsy revealed collapsing glomerulopathy. Droplet-based digital polymerase chain reaction did not detect the presence of SARS-CoV-2 RNA in the biopsy fragment, and the virus was barely detectable in plasma at the time of the biopsy. SARS-CoV-2 RNAemia peaked several days later, followed by a seroconversion despite the absence of circulating CD19-positive lymphocytes at admission due to rituximab-based treatment of antibody-mediated rejection 3 months earlier. Genotyping for the 2 risk alleles of the apolipoprotein L1 (APOL1) gene revealed that the donor carried the low-risk G0/G2 genotype. This case illustrates that coronavirus disease 2019 infection may promote a collapsing glomerulopathy in kidney allografts with a low-risk APOL1 genotype in the absence of detectable SARS-CoV-2 RNA in the kidney and that podocyte injury may precede SARS-CoV-2 RNAemia.
Identifiants
pubmed: 32668317
pii: S0272-6386(20)30790-3
doi: 10.1053/j.ajkd.2020.06.009
pmc: PMC7354772
pii:
doi:
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
590-594Informations de copyright
Copyright © 2020 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
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