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Membranous nephropathy in a patient with coronavirus disease 2019 (COVID-19): A case report.
Miao, Jing; Fidler, Mary E; Nasr, Samih H; Larsen, Christopher P; Zoghby, Ziad M.
  • Miao J; Division of Nephrology and Hypertension.
  • Fidler ME; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, and.
  • Nasr SH; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, and.
  • Larsen CP; Arkana Laboratories, Little Rock, AR, USA.
  • Zoghby ZM; Division of Nephrology and Hypertension.
Clin Nephrol Case Stud ; 9: 11-18, 2021.
Article in English | MEDLINE | ID: covidwho-1106317
ABSTRACT

INTRODUCTION:

Though respiratory, immune, and coagulation systems are major targets of coronavirus disease 2019 (COVID-19), kidney dysfunction, presenting with acute kidney injury (AKI), is also common. Most AKI cases in COVID-19 manifest as acute tubular injury (ATI) in conjunction with multiorgan failure. While initial renal pathological findings were limited to acute tubular necrosis and collapsing glomerulopathy, a recent case series reported a larger spectrum of findings. CASE REPORT Here, we report a case of membranous nephropathy (MN) in an 81-year-old Hispanic man with underlying chronic kidney disease (CKD) stage 3 who developed ATI in the setting of COVID-19. The patient was hospitalized for hypoxic respiratory failure in the setting of AKI stage 3 with serum creatinine 7.1 mg/dL 6 days after a positive-SARS-CoV-2 screening. He was found to have nephrotic range proteinuria, glycosuria (with normal serum glucose), anemia, and hypoalbuminemia. Kidney biopsy showed ATI and early MN. Workup for primary and secondary MN was unrevealing, and serum PLA2R antibody was negative. No viral particles were observed in podocytes.

CONCLUSION:

Although the MN could be incidental, this observation raises the question of whether SARS-CoV-2 infection can trigger or worsen an underlying MN from an exaggerated immune response associated with COVID-19.
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Full text: Available Collection: International databases Database: MEDLINE Type of study: Case report / Observational study / Prognostic study Language: English Journal: Clin Nephrol Case Stud Year: 2021 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Case report / Observational study / Prognostic study Language: English Journal: Clin Nephrol Case Stud Year: 2021 Document Type: Article