COVID-19 后移植肾供体携带高危 APOL1 变异患者新发局灶节段性肾小球硬化
De Novo Focal and Segmental Glomerulosclerosis After COVID-19 in a Patient With a Transplanted Kidney From a Donor With a High-risk APOL1 Variant.
机构信息
Assistance Publique des Hôpitaux de Paris, Hôpitaux Universitaires Henri-Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare "Syndrome Néphrotique Idiopathique", Fédération Hospitalo-Universitaire, Innovative Therapy for Immune Disorders, Créteil, France.
Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France.
出版信息
Transplantation. 2021 Jan 1;105(1):206-211. doi: 10.1097/TP.0000000000003432.
BACKGROUND
There is compelling evidence that renal complications in a native kidney are a major concern in patients infected with severe acute respiratory syndrome coronavirus 2, the causal agent of coronavirus disease 2019 (COVID-19). The spectrum of renal lesions observed on renal grafts in this context remains to be determined.
METHODS
We report the case of a renal transplant recipient with non-severe COVID-19, who subsequently developed nephrotic syndrome associated with acute renal injury.
RESULTS
Renal biopsy demonstrated focal and segmental glomerulosclerosis lesions classified as not otherwise specified histological variant. Genotyping for 2 risk alleles of the apolipoprotein L1 gene demonstrated that the donor was homozygous for the G2/G2 genotype.
CONCLUSIONS
In renal transplant patients receiving kidneys from donors with high-risk apolipoprotein L1 variants, COVID-19 may promote acute glomerular injury in the form of focal and segmental glomerulosclerosis.
背景
有确凿证据表明，新型冠状病毒 2（COVID-19 的病原体）感染患者的固有肾脏并发症是一个主要关注点。在这种情况下，在移植肾脏上观察到的肾脏病变谱仍有待确定。
方法
我们报告了一例患有非重症 COVID-19 的肾移植受者，随后出现肾病综合征伴急性肾损伤。
结果
肾活检显示局灶性和节段性肾小球硬化病变，分类为非特异性组织学变异型。载脂蛋白 L1 基因的 2 个风险等位基因的基因分型显示供体为 G2/G2 基因型纯合子。
结论
在接受高风险载脂蛋白 L1 变异体供肾的肾移植患者中，COVID-19 可能以局灶性和节段性肾小球硬化的形式导致急性肾小球损伤。
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