scholarly journals Clinical and pathological findings of SARS-CoV-2 infection and concurrent IgA nephropathy: A case report

2020 ◽  
Author(s):  
Liu Liu
Keyword(s):  
Renal Biopsy ◽  
Iga Nephropathy ◽  
Case Reports ◽  
Renal Involvement ◽  
Glomerular Disease ◽  
Angiotensin Ii Receptor Blocker ◽  
Limited Data ◽  
Angiotensin Ii Receptor ◽  
Macroscopic Hematuria ◽  
Renal Abnormalities

Abstract Background: Since the Coronavirus Disease 2019 (COVID-19) outbreak, there is limited data on the clinical characteristics, treatment strategies and prognosis of COVID-19 in patients with concurrent renal disease. The kidney is believed to have a predisposition for COVID-19 due to its abundant angiotensin-converting enzyme 2 (ACE2) expression, which acts as a cell entry receptor for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Recent postmortem investigations reveal renal involvement in COVID-19, and case reports describe collapsing glomerulopathy in African American patients with COVID-19. However, there is limited data regarding IgA nephropathy in the setting of COVID-19.Case presentation: In the present case, we report a 65-year old Chinese woman who presented with macroscopic hematuria, worsening proteinuria and decreased renal function after COVID-19 infection. She received a renal biopsy during COVID-19 infection. The renal biopsy revealed IgA nephropathy without any evidence for SARS-Cov-2. The findings suggest that the renal abnormalities were a consequence of exacerbation of this patient’s underlying glomerular disease after COVID-19 infection. After a regimen of 3-day course of glucocorticoid and angiotensin II receptor blocker therapy, the patient recovered and remained stable upon follow-up. Conclusions: It is important to consider the underlying glomerular disease exacerbation rather than virus induced injury when dealing with renal abnormalities in patients with COVID-19.

scholarly journals Clinical and pathological findings of SARS-CoV-2 infection and concurrent IgA nephropathy: a case report

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Yi Huang ◽  
Xiao-Juan Li ◽  
Yue-Qiang Li ◽  
Wei Dai ◽  
Tiffany Shao ◽  
...  
Keyword(s):  
Renal Biopsy ◽  
Iga Nephropathy ◽  
Renal Involvement ◽  
Treatment Strategies ◽  
Glomerular Disease ◽  
Angiotensin Ii Receptor Blocker ◽  
Limited Data ◽  
Angiotensin Ii Receptor ◽  
Renal Abnormalities

Abstract Background Since the Coronavirus Disease 2019 (COVID-19) outbreak, there is accumulating data on the clinical characteristics, treatment strategies and prognosis of COVID-19 in patients with concurrent renal disease. Postmortem investigations reveal renal involvement in COVID-19, and most recently, several biopsy researches reveal that acute tubular injury, as well as glomerular nephropathy such as collapsing glomerulopathy were common histological findings. However, to our best knowledge, there is limited data regarding IgA nephropathy in the setting of COVID-19. Case presentation In the present case, we report a 65-year old Chinese woman who presented with dark-colored urine, worsening proteinuria and decreased renal function after COVID-19 infection. She received a renal biopsy during COVID-19 infection. The renal biopsy revealed IgA nephropathy without any evidence for SARS-Cov-2. The findings suggest that the renal abnormalities were a consequence of exacerbation of this patient’s underlying glomerular disease after COVID-19 infection. After a regimen of 3-day course of glucocorticoid and angiotensin II receptor blocker therapy, the patient recovered and remained stable upon follow-up. Conclusions It is important to consider the underlying glomerular disease exacerbation as well as virus induced injury when dealing with renal abnormalities in patients with COVID-19. A kidney biopsy may be indicated to exclude a rapidly progressive glomerular disease.

Angiotensin II Receptor Blockers in Patients with ACE Inhibitor–Induced Angioedema

2000 ◽  
Vol 34 (4) ◽  
pp. 526-528 ◽  
Author(s):  
Kelly K Warner ◽  
James A Visconti ◽  
Marva M Tschampel
Keyword(s):  
Angiotensin Ii ◽  
Angiotensin Converting Enzyme ◽  
Ace Inhibitor ◽  
Case Reports ◽  
Angiotensin Ii Receptor Blockers ◽  
Prior History ◽  
Angiotensin Ii Receptor Blocker ◽  
Converting Enzyme ◽  
Angiotensin Ii Receptor ◽  
Receptor Blockers

OBJECTIVE: To determine the safety of using angiotensin II receptor blockers in patients who have experienced angioedema following treatment with angiotensin-converting enzyme (ACE) inhibitors. DATA SOURCES: Clinical literature identified through MEDLINE (January 1966–August 1999). Key search terms included angioneurotic edema, angiotensin-converting enzyme inhibitors, receptors–angiotensin, and losartan. DATA SYNTHESIS: ACE inhibitor–induced angioedema occurs with an incidence of 0.1–0.5%. Alternative therapy is necessary for patients who experience this potentially life-threatening adverse effect. Since angiotensin II receptor blockers do not increase concentrations of bradykinin, the proposed mechanism of ACE inhibitor–induced angioedema, they were presumed to be safe alternatives. Recent case reports, however, document angioedema following therapy with angiotensin II receptor blockers; 32% of the reported patients experienced a prior episode of angioedema attributed to ACE inhibitor therapy. CONCLUSIONS: Until the exact cause of both ACE inhibitor– and angiotensin II receptor blocker–induced angioedema is determined, angiotensin II receptor blockers should be used with extreme caution in patients with a prior history of angioedema.

scholarly journals A Case of Arteriovenous Fistula after Renal Biopsy in an IgA Nephropathy Patient with Macroscopic Hematuria

2013 ◽  
Vol 3 (1) ◽  
pp. 64-68 ◽  
Author(s):  
Satoshi Horikoshi ◽  
Akiko Takahata ◽  
Akihiko Shiraishi ◽  
Hiromitsu Fukuda ◽  
Isao Ohsawa ◽  
...  
Keyword(s):  
Renal Biopsy ◽  
Arteriovenous Fistula ◽  
Iga Nephropathy ◽  
Macroscopic Hematuria

scholarly journals P0488IG A NEPHROPATHY: ANALYSIS OF 501 BIOPSY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Marwa Omrane ◽  
Raja Aoudia ◽  
Mondher Ounissi ◽  
Soumaya Chargui ◽  
Mouna Jerbi ◽  
...  
Keyword(s):  
Renal Biopsy ◽  
Iga Nephropathy ◽  
Vascular Lesions ◽  
Macroscopic Hematuria ◽  
Systematic Screening ◽  
Female Ratio ◽  
Male Predominance ◽  
Glomerular Lesions ◽  
Stage Renal Disease ◽  
End Stage

Abstract Background and Aims Mesangial deposits Ig A was described the first time in 1968 by Berger and Hinglais. It remains the most common primary glomerulonephritis worldwide. It is often idiopathic but can also be secondary. The aim of our study is to describe the epidemiologic characteristics, the incidence and the anatomopathological features of 501 IgA nephropathy (IgA N) patients. Method It is a retrospective mono-centric study including patients having IgA N in the renal biopsy done in our department among a period of 17 years. Results We analyzed data of 8427 patients who underwent renal biopsy. 81% had glomerular nephropathy with 7.3% (501) IgA N. A male-to-female ratio of 2.27. The average age was 28.7 years. IgA N was primary in 80.2% cases and secondary in 17.8% cases. The most frequent secondary IgA N was rheumatoid purpura (74.8%). There was a male predominance in Berger‘s disease as well as in rheumatoid purpura. Berger’s disease was more common in adults, whereas rheumatoid purpura was more common in children. The main indication of renal biopsy was proteinuria with hematuria in 23.2% of cases and nephrotic syndrome in 23.8%. The association of non-nephrotic proteinuria, hematuria, arterial hypertension and renal injury was found in 9.3% whereas isolated macroscopic hematuria only in 6.4% of cases. According to HAAS classification, HAAS 3 was the most frequent. OXFORD classification used only from 2010, and M1, S1, E0, T0 and M1, S1, E0, T2 were the most frequent. Glomerular lesions were associated to tubulo interstitial and vascular lesions in 48.2% of cases. Conclusion IgA nephropathy is the most common glomerular disease and a frequent cause of end stage renal disease. Because of a clear increase of it’s incidence in our country and the delay in the diagnosis, a systematic screening of urines is needed in our country as it’s done in Singapore and Japan.

scholarly journals Pattern of glomerular diseases in biopsy proven native kidney in Western Nepal

2019 ◽  
Vol 8 (1) ◽  
pp. 5-8
Author(s):  
Abhishek Maskey ◽  
Lekhnath Lamsal
Keyword(s):  
Renal Biopsy ◽  
Iga Nephropathy ◽  
Kidney Biopsy ◽  
Kidney Diseases ◽  
Genetic Diseases ◽  
Safe Procedure ◽  
Macroscopic Hematuria ◽  
Glomerular Diseases ◽  
Histological Pattern ◽  
Perinephric Hematoma

Background and Aims: Kidney biopsy is decisive while evaluating for the diagnosis of glomerular, vascular, tubulointerstitial and genetic diseases. There is paucity of data on prevalence and pattern of various types of kidney diseases in Nepalese population. We describe various types of kidney diseases in patient population undergoing kidney biopsy at our centre. Methods: This is a prospective analysis of all patients, who underwent percutaneous renal biopsy at Manipal teaching hospital, over a duration of 30 months, i.e. August 2017 to January 2019. All kinds of kidney disease patients were included for kidney biopsy, irrespective of their clinical syndromes and underlying diagnosis. Results: A total of 175 consecutive biopsies were analyzed. The mean age of the patient was 35 } 15 years. Majority of the biopsy performed were in females. The majority of biopsy cases were age between 21-30 years of age. The youngest case to undergo renal biopsy was a child with asymptomatic isolated hematuria. The most frequent histological pattern observed in our study was IgA nephropathy (34.6%), followed by Focal segmental glomerulosclerosis (15.45%) and Membranous nephropathy (14.85%). Regarding complication macroscopic hematuria was seen in 15 (8.5%) cases and 8 (4.5%) cases had perinephric hematoma. There was no death related to renal biopsy. Conclusion: IgA nephropathy was the commonest histological pattern. Subnephrotic proteinuria was the commonest indication for biopsy. Complication of kidney biopsy is rare and considered safe procedure in clinical practice to determine diagnosis, prognosis and treatment.  

scholarly journals Renal hemosiderosis presenting with acute kidney Injury and macroscopic hematuria in Immunoglobulin A nephropathy: a case report

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Shinya Taguchi ◽  
Sumi Hidaka ◽  
Mitsuru Yanai ◽  
Kunihiro Ishioka ◽  
Kenji Matsui ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Biopsy ◽  
Prussian Blue ◽  
Iga Nephropathy ◽  
Acute Tubular Necrosis ◽  
Immunoglobulin A ◽  
Kidney Injury ◽  
Upper Respiratory Tract ◽  
Macroscopic Hematuria ◽  
Tubular Necrosis

Abstract Background Macroscopic hematuria-associated acute kidney injury (AKI) is a well-known complication of immunoglobulin A (IgA) nephropathy. In such cases, intratubular obstruction by red blood cell (RBC) casts and acute tubular necrosis are mainly observed pathologically. Herein, we report the case of a patient with IgA nephropathy presenting with AKI following an episode of macrohematuria. The patient presented with severe renal tubular hemosiderosis and acute tubular necrosis and without any obvious obstructive RBC casts. Case presentation A 68-year-old woman, who was diagnosed with IgA nephropathy on renal biopsy 6 years ago, was admitted to our hospital after an episode of macroscopic glomerular hematuria and AKI following upper respiratory tract infection. Renal biopsy showed mesangial proliferation of the glomeruli, including crescent formation in 17 % of the glomeruli, and acute tubular necrosis without obvious hemorrhage or obstructive RBC casts. The application of Perls’ Prussian blue stain showed hemosiderin deposition in the renal proximal tubular cells. Immunofluorescence showed granular mesangial deposits of IgA and C3. Based on these findings, she was diagnosed with acute tubular necrosis with a concurrent IgA nephropathy flare-up. Moreover, direct tubular injury by heme and iron was considered to be the cause of AKI. She was treated with intravenous pulse methylprednisolone followed by oral prednisolone. Thereafter, the gross hematuria gradually faded, and her serum creatinine levels decreased. Conclusions IgA nephropathy presenting with acute kidney injury accompanied by macrohematuria may cause renal hemosiderosis and acute tubular necrosis without obstructive RBC casts. Hemosiderosis may be a useful indicator for determining the pathophysiology of macroscopic hematuria-associated AKI. However, renal hemosiderosis may remain undiagnosed. Thus, Perls’ Prussian blue iron staining should be more widely used in patients presenting with hematuria.

scholarly journals A rare renal involvement in a patient with axial Spondyloarthritis: don’t miss focal segmental glomerulosclerosis and hyalinosis

2021 ◽  
Author(s):  
Tbini Houssem ◽  
Soumaya Boussaid ◽  
ikram mami ◽  
Sonia Rekik ◽  
Lilia Ben Fatma ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Renal Biopsy ◽  
Iga Nephropathy ◽  
Focal Segmental Glomerulosclerosis ◽  
Axial Spondyloarthritis ◽  
Renal Involvement ◽  
Segmental Glomerulosclerosis

Renal involvement in spondyloarthritis is dominated by amyloidosis, IgA nephropathy and urolithiasis. Other nephropathies are rare . A patient followed for SpA consults with edema , hydrocele and a pleural effusion. A FSGS was confirmed by renal biopsy and the etiological investigation has ruled out the causes of secondary FSGS.

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