A case of crescentic glomerulonephritis with exacerbation of pre-existing IgA nephropathy after COVID-19
Background. Relapses or new-onset IgA nephropathy (IgAN) have been documented in patients after vaccination against SARS-CoV-2; however, only one adult patient has been reported in whom pre-existing IgAN worsened during coronavirus disease 2019 (COVID-19). Case. We present the first pediatric ca...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Hacettepe University Institute of Child Health
2024-02-01
|
| Series: | The Turkish Journal of Pediatrics |
| Subjects: | |
| Online Access: | https://turkjpediatr.org/article/view/5114 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850240637732913152 |
|---|---|
| author | Esra Karabağ Yılmaz Seha Saygılı Gülüstan Musayeva Rüveyda Gülmez Ayşe Ağbaş Yasemin Özlük Nur Canpolat |
| author_facet | Esra Karabağ Yılmaz Seha Saygılı Gülüstan Musayeva Rüveyda Gülmez Ayşe Ağbaş Yasemin Özlük Nur Canpolat |
| author_sort | Esra Karabağ Yılmaz |
| collection | DOAJ |
| description |
Background. Relapses or new-onset IgA nephropathy (IgAN) have been documented in patients after vaccination against SARS-CoV-2; however, only one adult patient has been reported in whom pre-existing IgAN worsened during coronavirus disease 2019 (COVID-19).
Case. We present the first pediatric case with biopsy-proven IgAN and genetically confirmed Alport syndrome, who developed end-stage kidney disease after an exacerbation of IgAN associated with COVID-19. The patient’s basal serum creatinine was 0.7-0.9 mg/dL before infection. He had not been vaccinated against COVID-19. He was admitted to the hospital with edema, hypertension, an elevated serum creatinine of 4.7 mg/dL, and massive proteinuria. Three months before admission, he had been admitted to another hospital with COVID -19 and an elevated serum creatinine (1.9 mg/dL), but no biopsy had been performed at that time. The kidney biopsy revealed IgAN with 50% fibrocellular crescents with sclerosed glomeruli, tubular atrophy, and interstitial fibrosis. His serum creatinine did not decrease even after five administrations of pulse steroids, and hemodialysis was initiated.
Conclusion. In conclusion, COVID -19 may pose a high risk for exacerbation of pre-existing glomerular disease. It is therefore necessary to closely monitor the kidney function of patients with underlying glomerulonephritis during and after COVID-19 and consider an early biopsy if serum creatinine does not return to baseline levels. In addition, this case report highlights the clinical importance of the co-occurence of IgAN and Alport syndrome.
|
| format | Article |
| id | doaj-art-4e340e533dec4e04861dff2545645054 |
| institution | OA Journals |
| issn | 0041-4301 2791-6421 |
| language | English |
| publishDate | 2024-02-01 |
| publisher | Hacettepe University Institute of Child Health |
| record_format | Article |
| series | The Turkish Journal of Pediatrics |
| spelling | doaj-art-4e340e533dec4e04861dff25456450542025-08-20T02:00:47ZengHacettepe University Institute of Child HealthThe Turkish Journal of Pediatrics0041-43012791-64212024-02-0166110.24953/turkjped.2023.423A case of crescentic glomerulonephritis with exacerbation of pre-existing IgA nephropathy after COVID-19Esra Karabağ Yılmaz0https://orcid.org/0000-0002-6097-657XSeha Saygılı1https://orcid.org/0000-0002-2424-6959Gülüstan Musayeva2https://orcid.org/0009-0006-2896-6327Rüveyda Gülmez3https://orcid.org/0000-0001-5504-3516Ayşe Ağbaş4https://orcid.org/0000-0002-3658-8622Yasemin Özlük5https://orcid.org/0000-0002-7191-0488Nur Canpolat6https://orcid.org/0000-0002-3420-9756Department of Pediatric Nephrology, İstanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, İstanbul, TürkiyeDepartment of Pediatric Nephrology, İstanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, İstanbul, TürkiyeDepartment of Pediatrics, İstanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, İstanbul, TürkiyeDepartment of Pediatric Nephrology, İstanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, İstanbul, TürkiyeDepartment of Pediatric Nephrology, İstanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, İstanbul, TürkiyeDepartment of Pathology, İstanbul University Faculty of Medicine, İstanbul, TürkiyeDepartment of Pediatric Nephrology, İstanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, İstanbul, Türkiye Background. Relapses or new-onset IgA nephropathy (IgAN) have been documented in patients after vaccination against SARS-CoV-2; however, only one adult patient has been reported in whom pre-existing IgAN worsened during coronavirus disease 2019 (COVID-19). Case. We present the first pediatric case with biopsy-proven IgAN and genetically confirmed Alport syndrome, who developed end-stage kidney disease after an exacerbation of IgAN associated with COVID-19. The patient’s basal serum creatinine was 0.7-0.9 mg/dL before infection. He had not been vaccinated against COVID-19. He was admitted to the hospital with edema, hypertension, an elevated serum creatinine of 4.7 mg/dL, and massive proteinuria. Three months before admission, he had been admitted to another hospital with COVID -19 and an elevated serum creatinine (1.9 mg/dL), but no biopsy had been performed at that time. The kidney biopsy revealed IgAN with 50% fibrocellular crescents with sclerosed glomeruli, tubular atrophy, and interstitial fibrosis. His serum creatinine did not decrease even after five administrations of pulse steroids, and hemodialysis was initiated. Conclusion. In conclusion, COVID -19 may pose a high risk for exacerbation of pre-existing glomerular disease. It is therefore necessary to closely monitor the kidney function of patients with underlying glomerulonephritis during and after COVID-19 and consider an early biopsy if serum creatinine does not return to baseline levels. In addition, this case report highlights the clinical importance of the co-occurence of IgAN and Alport syndrome. https://turkjpediatr.org/article/view/5114Alport syndromechildrencrescentic glomerulonephritisCOVID-19IgA nephropathy |
| spellingShingle | Esra Karabağ Yılmaz Seha Saygılı Gülüstan Musayeva Rüveyda Gülmez Ayşe Ağbaş Yasemin Özlük Nur Canpolat A case of crescentic glomerulonephritis with exacerbation of pre-existing IgA nephropathy after COVID-19 The Turkish Journal of Pediatrics Alport syndrome children crescentic glomerulonephritis COVID-19 IgA nephropathy |
| title | A case of crescentic glomerulonephritis with exacerbation of pre-existing IgA nephropathy after COVID-19 |
| title_full | A case of crescentic glomerulonephritis with exacerbation of pre-existing IgA nephropathy after COVID-19 |
| title_fullStr | A case of crescentic glomerulonephritis with exacerbation of pre-existing IgA nephropathy after COVID-19 |
| title_full_unstemmed | A case of crescentic glomerulonephritis with exacerbation of pre-existing IgA nephropathy after COVID-19 |
| title_short | A case of crescentic glomerulonephritis with exacerbation of pre-existing IgA nephropathy after COVID-19 |
| title_sort | case of crescentic glomerulonephritis with exacerbation of pre existing iga nephropathy after covid 19 |
| topic | Alport syndrome children crescentic glomerulonephritis COVID-19 IgA nephropathy |
| url | https://turkjpediatr.org/article/view/5114 |
| work_keys_str_mv | AT esrakarabagyılmaz acaseofcrescenticglomerulonephritiswithexacerbationofpreexistingiganephropathyaftercovid19 AT sehasaygılı acaseofcrescenticglomerulonephritiswithexacerbationofpreexistingiganephropathyaftercovid19 AT gulustanmusayeva acaseofcrescenticglomerulonephritiswithexacerbationofpreexistingiganephropathyaftercovid19 AT ruveydagulmez acaseofcrescenticglomerulonephritiswithexacerbationofpreexistingiganephropathyaftercovid19 AT ayseagbas acaseofcrescenticglomerulonephritiswithexacerbationofpreexistingiganephropathyaftercovid19 AT yaseminozluk acaseofcrescenticglomerulonephritiswithexacerbationofpreexistingiganephropathyaftercovid19 AT nurcanpolat acaseofcrescenticglomerulonephritiswithexacerbationofpreexistingiganephropathyaftercovid19 AT esrakarabagyılmaz caseofcrescenticglomerulonephritiswithexacerbationofpreexistingiganephropathyaftercovid19 AT sehasaygılı caseofcrescenticglomerulonephritiswithexacerbationofpreexistingiganephropathyaftercovid19 AT gulustanmusayeva caseofcrescenticglomerulonephritiswithexacerbationofpreexistingiganephropathyaftercovid19 AT ruveydagulmez caseofcrescenticglomerulonephritiswithexacerbationofpreexistingiganephropathyaftercovid19 AT ayseagbas caseofcrescenticglomerulonephritiswithexacerbationofpreexistingiganephropathyaftercovid19 AT yaseminozluk caseofcrescenticglomerulonephritiswithexacerbationofpreexistingiganephropathyaftercovid19 AT nurcanpolat caseofcrescenticglomerulonephritiswithexacerbationofpreexistingiganephropathyaftercovid19 |