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Viruses . IgA-Dominant Infection-Associated Glomerulonephritis Following SARS-CoV-2 Infection

tetano

Editor, Senior Moderator
Viruses


. 2021 Mar 31;13(4):587.
doi: 10.3390/v13040587.
IgA-Dominant Infection-Associated Glomerulonephritis Following SARS-CoV-2 Infection


Aurora P?rez[SUP] 1 [/SUP], Isidro Torregrosa[SUP] 1 [/SUP], Luis D'Marco[SUP] 1 [/SUP], Isabel Juan[SUP] 1 [/SUP], Liria Terradez[SUP] 2 [/SUP], Miguel ?ngel Sol?s[SUP] 1 [/SUP], Francesc Moncho[SUP] 1 [/SUP], Carmen Carda-Batalla[SUP] 2 [/SUP], Mar?a J Forner[SUP] 3 [/SUP], Jose Luis Gorriz[SUP] 1 [/SUP]



Affiliations

Abstract

The renal involvement of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been reported. The etiology of kidney injury appears to be tubular, mainly due to the expression of angiotensin-converting enzyme 2, the key joint receptor for SARS-CoV-2; however, cases with glomerular implication have also been documented. The multifactorial origin of this renal involvement could include virus-mediated injury, cytokine storm, angiotensin II pathway activation, complement dysregulation, hyper-coagulation, and microangiopathy. We present the renal histological findings from a patient who developed acute kidney injury and de novo nephrotic syndrome, highly suggestive of acute IgA-dominant infection-associated glomerulonephritis (IgA-DIAGN) after SARS-CoV-2 infection, as evidenced by the presence of this virus detected in the renal tissue of the patient via immunohistochemistry assay. In summary, we document the first case of IgA-DIAGN associated to SARS-CoV-2. Thus, SARS-CoV-2 S may act as a super antigen driving the development of multisystem inflammatory syndrome as well as cytokine storm in patients affected by COVID-19, reaching the glomerulus and leading to the development of this novel IgA-DIAGN.

Keywords: COVID-19; SARS-CoV-2; acute kidney injury; glomerulonephritis.
 
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