Lessons for the clinical nephrologist: recurrence of nephrotic syndrome induced by SARS-CoV-2

• DOI: 10.1007/s40620-020-00855-5
• Publication Date: 2020-09-05T17:02:36Z
• Authors: Adrian A. N. Doev...; Bodo Hölzer; Felix S. Seibert; Frederic Bauer; Ulrik Stervbo; Benjamin J. Rohn; Panagiota Zgoura; Peter Schenker; Eva Vonbrunn; Kerstin Amann; Richard Viebahn; Nina Babel; Timm H. Westhoff
• Keywords: Nephrology; Acute tubular necrosis

Abstract SARS-CoV-2 is characterized by a multiorgan tropism including the kidneys. Recent autopsy series indicated that can infect both tubular and glomerular cells. Whereas cell infiltration may contribute to acute kidney injury, data on potential clinical correlative affection rare. We describe first case of nephrotic syndrome in context COVID-19 renal transplant recipient. A 35 year old male patient received allograft for primary focal segmental glomerulosclerosis (FSGS). Three months posttransplant recurrence podocytopathy was successfully managed plasma exchange, ivIG, conversion from tacrolimus belatacept (initial proteinuria > 6 g/l decreased 169 mg/l). Six weeks later he tested positive developed second increase (5.6 g/l). Renal biopsy revealed diffuse podocyte effacement RNA in-situ hybridation indicating associated podocytopathy. Noteworthy, resolved spontaneously after recovering COVID-19. The present expands spectrum involvement injury recipients. Thus, it be wise test prior initiation immunosuppression new onset glomerulopathy during pandemic.