ABSTRACT
Novel coronavirus disease infection (coronavirus disease 2019, COVID-19) was declared a global pandemic in March 2020 and since then has become a major public health problem. The prevalence of COVID-19 infection and acute kidney injury (AKI) is variable depending on several factors such as race/ethnicity and severity of illness. The pathophysiology of renal involvement in COVID-19 infection is not entirely clear, but it could be in part explained by the viral tropism in the kidney parenchyma. AKI in COVID-19 infection can be either by direct invasion of the virus or as a consequence of immunologic response. Diverse studies have focused on the effect of COVID-19 on glomerulonephritis (GN) patients or the 'novo' GN; however, the effect of COVID-19 in acute tubulointerstitial nephritis (ATIN) has been scarcely studied. In this article, we present five cases with different spectrums of COVID-19 infection and ATIN that may suggest that recent diagnosis of ATIN is accompanied by a worse clinical prognosis in comparison with long-term diagnosed ATIN.
ABSTRACT
The COVID-19 pandemic caused by coronavirus SARS-CoV-2 is currently a main public health problem worldwide. The clinical symptoms relate primarily to the respiratory system but may also involve multiple organs. The course of COVID-19 in children is usually mild, but in some cases may cause late complications, particularly the pediatric inflammatory multisystem syndrome (PIMS-TS). One of its symptoms may be acute kidney injury. We present a 10-year-old boy who developed nonspecific symptoms a few weeks after mild COVID-19, including weakness, weight loss, and polyuria. Clinical evaluation revealed acute renal failure secondary to acute tubulointerstitial nephritis (ATIN). Treatment with glucocorticoids resulted in rapid clinical and laboratory improvement. We hypothesize that the development of ATIN could be causally related to COVID-19 in an immune pathomechanism similar to PIMS-TS. The case provides new insights into possible complications of SARS-CoV-2 infection and indicates the need for renal follow-up after COVID-19. © 2021 Termedia Publishing House Ltd.. All rights reserved.
ABSTRACT
Coronavirus disease 2019 (COVID-19) is an ongoing pandemic that to date has spread to >100 countries. Acute kidney injury is not uncommon with this disease. The most common kidney biopsy finding is acute tubular injury. Glomerular diseases such as collapsing glomerulopathy and vasculitis, and thrombotic microangiopathy have been reported. Viral inclusion particles with distinctive spikes in the tubular epithelium and podocytes, and endothelial cells of the glomerular capillary loops, have been visualized by electron microscopy by some but disputed by others as non-viral structures. Interstitial infiltrates have not commonly been described in the published kidney biopsy series from patients with COVID-19. Medications used to treat COVID-19 can lead to interstitial nephritis, but very few have been reported. In summary, interstitial kidney disease is a rare finding in COVID-19.