A case of crescentic glomerulonephritis in a patient with COVID-19 infection

Rationale:

Kidney involvement with COVID-19 infection is a well-known complication, and the majority of kidney involvement is related to ischemic injury/acute tubular injury. However, there are some cases of glomerulonephritis, the etiology of which is not yet known, but an immune process is likely to be the trigger.

Patient concerns:

A 27-year-old man presented to our hospital with facial puffiness and lower-limb swelling.

Diagnosis:

Laboratory assessment revealed features of impaired kidney function with proteinuria and hematuria; COVID-19 polymerase chain reaction was positive, which was consistent with pauci-immune crescentic focal segmental glomerulonephritis.

Intervention:

After renal biopsy, the patient was started on methylprednisolone and rituximab. Due to worsening kidney parameters, he underwent intermittent hemodialysis as needed.

Outcome:

Kidney function tests partially improved; he was discharged on oral steroids with follow-up in the nephrology clinic to observe for the need for further hemodialysis.

Lessons:

We conducted a literature review of cases of glomerulonephritis associated with COVID-19 and described numerous types of glomerulonephritis. This report highlights the importance of recognizing emerging glomerulonephritis with COVID-19, the different pathological patterns of renal biopsies, and management interventions and responses.

Other Information

Published in: Medicine
License: http://creativecommons.org/licenses/by/4.0
See article on publisher's website: https://dx.doi.org/10.1097/md.0000000000028754