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COVID-19 相关的塌陷性肾小球病:两例病例报告及文献复习。

COVID-19-associated collapsing glomerulopathy: a report of two cases and literature review.

机构信息

Department of Nephrology, Peupliers Private Hospital, Ramsay Générale de Santé, Paris, France.

Department of Pathology, Sorbonne University, Assistance Publique-Hôpitaux de Paris, Groupement Hospitalier Pitié-Salpêtrière, Paris, France.

出版信息

Intern Med J. 2020 Dec;50(12):1551-1558. doi: 10.1111/imj.15041.

Abstract

Nephrotic range proteinuria has been reported during the course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease (COVID-19). However, the pathological mechanisms underlying this manifestation are unknown. In this article, we present two cases of collapsing glomerulopathy (CG) associated with acute tubular necrosis during the course of COVID-19, and review the literature for similar reports. In our two cases, as in the 14 cases reported so far, the patients were of African ancestry. The 14 patients assessed had an APOL1 high-risk genotype. At the end of the reported period, two patients had died and five patients were still requiring dialysis. The 16 cases detailed in the present report strongly argue in favour of a causal link between SARS-CoV-2 infection and the occurrence of CG in patients homozygous for APOL1 high-risk genotype for which the term COVID-associated nephropathy (COVIDAN) can be put forward.

摘要

肾病范围蛋白尿已在严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)和冠状病毒病(COVID-19)的病程中报告。然而,这种表现的病理机制尚不清楚。在本文中,我们报告了 COVID-19 病程中合并急性肾小管坏死的 2 例塌陷性肾小球病(CG)病例,并对类似病例进行了文献复习。在我们的两个病例中,与迄今报告的 14 例病例一样,患者为非洲裔。评估的 14 例患者具有 APOL1 高危基因型。在报告期结束时,2 例患者死亡,5 例患者仍需要透析。本报告详细介绍的 16 例病例强烈支持 SARS-CoV-2 感染与 APOL1 高危基因型纯合子患者 CG 的发生之间存在因果关系,可提出 COVID-19 相关性肾病(COVIDAN)这一术语。

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