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COVID-19–Related Collapsing Glomerulopathy in a Kidney Transplant Recipient

Abstract : We report a case of a kidney transplant recipient who presented with acute kidney injury and nephrotic-range proteinuria in a context of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Kidney biopsy revealed collapsing glomerulopathy. Droplet-based digital polymerase chain reaction did not detect the presence of SARS-CoV-2 RNA in the biopsy fragment, and the virus was barely detectable in plasma at the time of the biopsy. SARS-CoV-2 RNAemia peaked several days later, followed by a seroconversion despite the absence of circulating CD19-positive lymphocytes at admission due to rituximab-based treatment of antibody-mediated rejection 3 months earlier. Genotyping for the 2 risk alleles of the apolipoprotein L1 (APOL1) gene revealed that the donor carried the low-risk G0/G2 genotype. This case illustrates that coronavirus disease 2019 infection may promote a collapsing glomerulopathy in kidney allografts with a low-risk APOL1 genotype in the absence of detectable SARS-CoV-2 RNA in the kidney and that podocyte injury may precede SARS-CoV-2 RNAemia.
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Submitted on : Thursday, September 22, 2022 - 3:39:09 PM
Last modification on : Wednesday, September 28, 2022 - 4:20:12 PM


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Hélène Lazareth, Hélène Péré, Yannick Binois, Melchior Chabannes, Juliet Schurder, et al.. COVID-19–Related Collapsing Glomerulopathy in a Kidney Transplant Recipient. American Journal of Kidney Diseases, 2020, 76, pp.590 - 594. ⟨10.1053/j.ajkd.2020.06.009⟩. ⟨hal-03491270⟩



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