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Kidney transplant dysfunction in a patient with COVID - 19 infection : role of concurrent Sars-Cov 2 nephropathy, chronic rejection and vitamin C-mediated hyperoxalosis : case report.
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Anandh, Urmila, Gowrishankar, Swarnalata, Sharma, Alok, Salama, Alan and Dasgupta, Indranil (2021) Kidney transplant dysfunction in a patient with COVID - 19 infection : role of concurrent Sars-Cov 2 nephropathy, chronic rejection and vitamin C-mediated hyperoxalosis : case report. BMC Nephrology, 22 (1). 91. doi:10.1186/s12882-021-02298-x ISSN 1471-2369.
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Official URL: https://doi.org/10.1186/s12882-021-02298-x
Abstract
COVID-19 infection in kidney transplant recipients often lead to allograft dysfunction. The allograft injury has various histopathological manifestations. Our case illustrates the unusual combination of allograft rejection, acute kidney injury secondary to oxalate nephropathy and SARS CoV-2 nephropathy as the cause of irreversible allograft failure. A 56 year old renal allograft recipient presented with a history of fever and diarrhoea for the preceding 4 weeks, tested positive for Sars-CoV2 on nasal swab and was found to have severe allograft dysfunction, necessitating haemodialysis. He subsequently underwent an allograft biopsy, which demonstrated antibody mediated rejection along with the presence of extensive oxalate deposition in the tubules. Ultrastructural examination demonstrated spherical spiked particles in the glomerular capillary endothelium and the presence of tubulo-reticular inclusions suggestive of an active COVID-19 infection within the kidney. The intra-tubular oxalate deposition was considered to be the result of high dose, supplemental Vitamin C used as an immune booster in many patients with COVID - 19 infection in India. This case highlights the complex pathology that may be seen in following COVID-19 disease and the need for kidney biopsies in these patients to better understand the aetiology of disease.
Item Type: | Journal Article | ||||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School | ||||||
SWORD Depositor: | Library Publications Router | ||||||
Journal or Publication Title: | BMC Nephrology | ||||||
Publisher: | BioMed Central Ltd. | ||||||
ISSN: | 1471-2369 | ||||||
Official Date: | 15 March 2021 | ||||||
Dates: |
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Volume: | 22 | ||||||
Number: | 1 | ||||||
Article Number: | 91 | ||||||
DOI: | 10.1186/s12882-021-02298-x | ||||||
Status: | Peer Reviewed | ||||||
Publication Status: | Published | ||||||
Access rights to Published version: | Open Access (Creative Commons) |
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