The renal involvement of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been reported. The etiology of kidney injury appears to be tubular, mainly due to the expression of angiotensin-converting enzyme 2, the key joint receptor for SARS-CoV-2; however, cases with glomerular implication have also been documented. The multifactorial origin of this renal involvement could include virus-mediated injury, cytokine storm, angiotensin II pathway activation, complement dysregulation, hyper-coagulation, and microangiopathy. We present the renal histological findings from a patient who developed acute kidney injury and de novo nephrotic syndrome, highly suggestive of acute IgA-dominant infection-associated glomerulonephritis (IgA-DIAGN) after SARS-CoV-2 infection, as evidenced by the presence of this virus detected in the renal tissue of the patient via immunohistochemistry assay. In summary, we document the first case of IgA-DIAGN associated to SARS-CoV-2. Thus, SARS-CoV-2 S may act as a super antigen driving the development of multisystem inflammatory syndrome as well as cytokine storm in patients affected by COVID-19, reaching the glomerulus and leading to the development of this novel IgA-DIAGN.
【저자키워드】 COVID-19, SARS-CoV-2, Acute kidney injury, Glomerulonephritis, 【초록키워드】 immunohistochemistry, Cytokine storm, coronavirus, SARS-COV-2 infection, cytokine, Acute kidney injury, severe acute respiratory syndrome Coronavirus, virus, angiotensin-converting enzyme 2, Antigen, Kidney injury, Glomerulonephritis, Patient, pathway, receptor, respiratory, etiology, expression, Angiotensin-converting enzyme, Angiotensin II, angiotensin, Inflammatory, Injury, microangiopathy, nephrotic syndrome, dysregulation, Renal involvement, acute respiratory syndrome, Activation, joint receptor, acute respiratory syndrome coronavirus, acute respiratory syndrome coronavirus 2, syndrome, SARS-CoV-2 S, renal, complement dysregulation, glomerulus, renal tissue, tubular, de novo, driving, multifactorial, joint, affected, include, reported, the patient, appear, evidenced, histological, glomerular,