1. Minimal Change Disease With Nephrotic Syndrome Associated With Coronavirus Disease 2019 After Apolipoprotein L1 Risk Variant Kidney Transplant: A Case Report.
- Author
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Yamada M, Rastogi P, Ince D, Thayyil A, Adela Mansilla M, Smith RJH, Kuppachi S, and Thomas CP
- Subjects
- Betacoronavirus, COVID-19, Female, Humans, Kidney Transplantation, Middle Aged, Pandemics, SARS-CoV-2, Apolipoprotein L1 genetics, Coronavirus Infections immunology, Immunocompromised Host, Nephrosis, Lipoid genetics, Nephrosis, Lipoid virology, Pneumonia, Viral immunology
- Abstract
Kidney injury is a well-known complication in people with coronavirus disease 2019 (COVID-19). In kidney transplant recipients with COVID-19, presentation with nephrotic syndrome has not been well described. We report on a 49-year-old black female kidney transplant recipient who presented 25 years after transplant with clinical features of nephrotic syndrome following a diagnosis of COVID-19. Histologic examination showed acute tubular injury with unremarkable glomeruli on light microscopy and diffuse foot process effacement of podocytes on electron microscopy, consistent with minimal change-like podocyte injury. Apolipoprotein L1 (APOL1) genetic testing confirmed 2 high-risk APOL1 alleles in the kidney donor. We speculate that COVID-19-induced systemic or local cytokine release could serve as a second hit in the presence of APOL1 risk alleles and mediate a podocytopathy manifesting as nephrotic syndrome. The presented case with minimal change-like disease, occurring in the context of the donor high-risk APOL1 genotype, extends the spectrum of clinical manifestations in COVID-19-associated nephropathy., (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Published
- 2020
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