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Case Reports: Unusual association of diseases/symptoms
Diffuse proliferative glomerulonephritis in a patient with COVID-19 infection
  1. Vincent Albert Galvez Flores1,
  2. Sonia Chicano2,
  3. Lourdes Paula Resontoc1 and
  4. Eric Emmanuel Aragon1
  1. 1Department of Pediatrics, Division of Pediatric Nephrology, University of the Philippines Manila, Manila, Philippines
  2. 2Department of Laboratory Medicine, National Kidney and Transplant Institute, Quezon City, Philippines
  1. Correspondence to Dr Vincent Albert Galvez Flores; vincentalbertflores{at}gmail.com

Abstract

COVID-19 primarily presents with respiratory involvement. Extrapulmonary manifestations as the sole manifestation also occur although rare. The kidney, being one of the organs with the greatest number of ACE receptors, is usually reported as part of multiorgan involvement. We report an early adolescent boy who presented with nephrotic–nephritic syndrome with severe kidney dysfunction from COVID-19 infection. He had low C3 and undetected antineutrophil cytoplasmic antibodies, antinuclear antibody and antistreptolysin O. Kidney biopsy revealed findings consistent with diffuse proliferative glomerulonephritis with a focal glomerular crescent formation and thin basement nephropathy. Due to the rapidly progressive deterioration of kidney function, he was given pulse methylprednisolone therapy followed by oral prednisone. Complete recovery was documented 12 weeks after the onset of post-infectious glomerulonephritis. The possible pathogenesis of glomerulonephritis in a patient with COVID-19, its differential diagnosis and treatment are discussed.

  • COVID-19
  • Nephrotic syndrome
  • Acute renal failure

http://dx.doi.org/10.1136/bcr-2022-251962

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    Footnotes

    • Contributors The authors confirm contribution to the paper as follows: study conception and design, and data collection—VAGF, LPR and EEA; analysis and interpretation of results—VAGF, LPR, SC and EEA. All authors reviewed the results and approved the final version of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.