COVID-19-Related Collapsing Glomerulopathy in a Kidney Transplant Recipient.
Am J Kidney Dis
; 76(4): 590-594, 2020 10.
Article
in English
| MEDLINE | ID: covidwho-638918
ABSTRACT
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.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Glomerulonephritis, Membranous
/
Kidney Transplantation
/
Coronavirus Infections
/
Transplant Recipients
/
Kidney
Type of study:
Case report
/
Diagnostic study
/
Observational study
/
Prognostic study
Limits:
Adult
/
Humans
/
Male
Language:
English
Journal:
Am J Kidney Dis
Year:
2020
Document Type:
Article
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