Kidney transplant dysfunction in a patient with COVID - 19 infection: role of concurrent Sars-Cov 2 nephropathy, chronic rejection and vitamin C-mediated hyperoxalosis: case report.
BMC Nephrol
; 22(1): 91, 2021 03 15.
Article
in English
| MEDLINE | ID: covidwho-1136213
ABSTRACT
BACKGROUND:
COVID-19 infection in kidney transplant recipients often lead to allograft dysfunction. The allograft injury has various histopathological manifestations. Our case illustrates the unusual combination of allograft rejection, acute kidney injury secondary to oxalate nephropathy and SARS CoV-2 nephropathy as the cause of irreversible allograft failure. CASE PRESENTATION A 56 year old renal allograft recipient presented with a history of fever and diarrhoea for the preceding 4 weeks, tested positive for Sars-CoV2 on nasal swab and was found to have severe allograft dysfunction, necessitating haemodialysis. He subsequently underwent an allograft biopsy, which demonstrated antibody mediated rejection along with the presence of extensive oxalate deposition in the tubules. Ultrastructural examination demonstrated spherical spiked particles in the glomerular capillary endothelium and the presence of tubulo-reticular inclusions suggestive of an active COVID-19 infection within the kidney. The intra-tubular oxalate deposition was considered to be the result of high dose, supplemental Vitamin C used as an immune booster in many patients with COVID - 19 infection in India.CONCLUSIONS:
This case highlights the complex pathology that may be seen in following COVID-19 disease and the need for kidney biopsies in these patients to better understand the aetiology of disease.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Ascorbic Acid
/
Hyperoxaluria
/
Kidney Transplantation
/
Primary Graft Dysfunction
/
COVID-19
/
Graft Rejection
Type of study:
Case report
/
Diagnostic study
/
Etiology study
/
Prognostic study
Topics:
Long Covid
/
Vaccines
Limits:
Humans
/
Male
/
Middle aged
Language:
English
Journal:
BMC Nephrol
Journal subject:
Nephrology
Year:
2021
Document Type:
Article
Affiliation country:
S12882-021-02298-x
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