Kadariya Karishma, Soji-Ayoade Demilade, Isaac Sangeetha, Paul Subir
Internal Medicine, North Alabama Medical Center, Florence, USA.
Nephrology, North Alabama Medical Center, Florence, USA.
Cureus. 2023 Feb 23;15(2):e35372. doi: 10.7759/cureus.35372. eCollection 2023 Feb.
With the increasing number of COVID-19-associated nephropathy (COVAN), biopsy-proven cases of collapsing variety of focal segmental glomerulosclerosis (FSGS) are emerging. Though the recommendations on treatment for COVID-19-associated respiratory symptoms are evolving, there is still no definitive treatment for the collapsing FSGS secondary to COVAN. We report a case of a 47-year-old male admitted with acute kidney injury from COVID-19 infection and found to have collapsing FSGS on renal biopsy. Almost all the patients who were found to have similar conditions were treated with a relatively smaller dose of steroids and ultimately required dialysis. Our patient showed improvement with the trial of higher doses of steroids and never required dialysis. Hence, our case report emphasizes the need for a randomized controlled trial (RCT) with regard to the use of high-dose steroids in COVAN.
随着新型冠状病毒肺炎相关性肾病（COVAN）病例数的增加，经活检证实的塌陷型局灶节段性肾小球硬化（FSGS）病例不断出现。尽管针对新型冠状病毒肺炎相关呼吸道症状的治疗建议不断演变，但对于COVAN继发的塌陷型FSGS仍没有确切的治疗方法。我们报告一例47岁男性患者，因新型冠状病毒肺炎感染导致急性肾损伤入院，肾活检发现为塌陷型FSGS。几乎所有被发现有类似情况的患者都接受了相对较小剂量的类固醇治疗，最终需要透析。我们的患者在尝试使用更高剂量的类固醇后病情有所改善，且从未需要透析。因此，我们的病例报告强调了针对在COVAN中使用高剂量类固醇进行随机对照试验（RCT）的必要性。
