Kidney involvement and histological findings in two pediatric COVID-19 patients.
Pediatr Nephrol
; 36(11): 3789-3793, 2021 11.
Article
in English
| MEDLINE | ID: covidwho-1361293
ABSTRACT
BACKGROUND:
Histological findings of kidney involvement have been rarely reported in pediatric patients with SARS-CoV-2 infection. Here, we describe clinical, laboratory, and histological findings of two pediatric cases with almost exclusive kidney involvement by SARS-CoV-2.RESULTS:
A 10-year-old girl with IgA vasculitis nephritis underwent kidney biopsy, showing diffuse and segmental mesangial-proliferative glomerulonephritis, and steroid therapy was initiated. After the worsening of the clinical picture, including an atypical skin rash, she was diagnosed with SARS-CoV-2. The re-evaluation of initial biopsy showed cytoplasmatic blebs and virus-like particles in tubular cells at electron microscopy. Despite SARS-CoV-2 clearance and the intensification of immunosuppression, no improvement was observed. A second kidney biopsy showed a crescentic glomerulonephritis with sclerosis, while virus-like particles were no longer evident. The second patient was a 12-year-old girl with a 3-week history of weakness and weight loss. Rhinitis was reported the month before. No medications were being taken. Blood and urine analysis revealed elevated serum creatinine, hypouricemia, low molecular weight proteinuria, and glycosuria. A high SARS-CoV-2-IgG titre was detected. Kidney biopsy showed acute tubular-interstitial nephritis. Steroid therapy was started with a complete resolution of kidney involvement.CONCLUSION:
We can speculate that in both cases SARS-CoV-2 played a major role as inflammatory trigger of the kidney damage. Therefore, we suggest investigating the potential kidney damage by SARS-CoV-2 in children. Moreover, SARS-CoV-2 can be included among infectious agents responsible for pediatric acute tubular interstitial nephritis.Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
SARS-CoV-2
/
COVID-19
/
Glomerulonephritis, IGA
/
Kidney
/
Nephritis, Interstitial
Type of study:
Case report
/
Diagnostic study
/
Experimental Studies
/
Prognostic study
Topics:
Long Covid
Limits:
Child
/
Female
/
Humans
Language:
English
Journal:
Pediatr Nephrol
Journal subject:
Nephrology
/
Pediatrics
Year:
2021
Document Type:
Article
Affiliation country:
S00467-021-05212-7
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