Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2020 Nov;52(9):2693-2697.
doi: 10.1016/j.transproceed.2020.08.012. Epub 2020 Aug 20.

Minimal Change Disease With Nephrotic Syndrome Associated With Coronavirus Disease 2019 After Apolipoprotein L1 Risk Variant Kidney Transplant: A Case Report

Masaaki Yamada  1 , Prerna Rastogi  2 , Dilek Ince  3 , Abdullah Thayyil  4 , M Adela Mansilla  5 , Richard J H Smith  6 , Sarat Kuppachi  7 , Christie P Thomas  1
Affiliations
Case Reports

Minimal Change Disease With Nephrotic Syndrome Associated With Coronavirus Disease 2019 After Apolipoprotein L1 Risk Variant Kidney Transplant: A Case Report

Masaaki Yamada et al. Transplant Proc. 2020 Nov.

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.

PubMed Disclaimer

Figures

Fig 1
Fig 1
Kidney biopsy. (A) Periodic acid–Schiff stain (× 400), normal glomerulus without crescent, spikes and holes, or basement membrane reduplication and acute tubular injury. No tubulitis was seen. (B) Ultrastructural examination shows extensive foot process effacement with microvillous transformation. (C) Tubuloreticular inclusion noted in capillary loop endothelial cells (white arrowhead). CL, capillary lumen; EM, electron microscopy; PAS, periodic acid–Schiff stain; US, urinary space.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Zhou F., Yu T., Du R., Fan G., Liu Y., Liu Z. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395:1054–1062. - PMC - PubMed
    1. Hirsch J.S., Ng J.H., Ross D.W., Sharma P., Shah H.H., Barnett R.L. Acute kidney injury in patients hospitalized with COVID-19. Kidney Int. 2020;98:209–218. - PMC - PubMed
    1. Larsen C.P., Bourne T.D., Wilson J.D., Saqqa O., Sharshir M.A. Collapsing glomerulopathy in a patient with COVID-19. Kidney Int Rep. 2020;5:935–939. - PMC - PubMed
    1. Kissling S., Rotman S., Gerber C., Halfon M., Lamoth F., Comte D. Collapsing glomerulopathy in a COVID-19 patient. Kidney Int. 2020;98:228–231. - PMC - PubMed
    1. Wu H., Larsen C.P., Hernandez-Arroyo C.F., Mohamed M.M.B., Caza T., Sharshir M. AKI and collapsing glomerulopathy associated with COVID-19 and APOL 1 High-Risk Genotype. J Am Soc Nephrol. 2020;31:1688–1695. - PMC - PubMed

Publication types