key: cord-0770667-h962jgg8
authors: Mat, Olivier; Ghisdal, Lidia; Massart, Annick; Aydin, Selda; Goubella, Ahmed; Blankoff, Niko; Gankam, Fabrice; Debelle, Frédéric; Mat, Quentin
title: Kidney Thrombotic MicroAngiopathy after COVID-19 associated with C3 gene mutation
date: 2021-04-08
journal: Kidney Int Rep
DOI: 10.1016/j.ekir.2021.03.897
sha: 32c51d1b4064eaad18bc5eef3343b5bed8765aa5
doc_id: 770667
cord_uid: h962jgg8

nan

Acute kidney injury (AKI) is not uncommon in patients with COVID-19 but thrombotic 2 microangiopathy (TMA) linked to COVID-19 has been exceptionally reported in another 3 patient (1). However, COVID-infected patients can develop proteinuria (44%), hematuria 4 (27%) or acute kidney injury (AKI) (5.1%) (2). We report a case of atypical Hemolytic 5 Uremic Syndrome (aHUS) associated with COVID-19. This case highlights the importance of 6 a rapid diagnosis, a good medical history and a genetic analysis to optimize the management 7 of this rare disease. We remind the role of complement pathways in the pathophysiology of 8 IgA nephropathy and COVID-19 infection. Treatment of aHUS usually requires the use of 9 therapeutic plasma exchange (TPE) and eculizumab, a monoclonal antibody C5-inhibitor that 10 drastically changed the prognosis of TMA. We also wanted to know if TPE impede natural 11 humoral immunity against COVID-19

A 39-year-old fireman was admitted to our Nephrology unit for weariness, acute renal failure, 14 diarrhea and fever (37.5-38°C) for 6 days. His medical history included hypertension, low-15 grade esophagitis and moderate chronic kidney disease (last eGFR 45 ml/min/1.73m², serum 16 creatinine 2.1 mg % and residual proteinuria of 1.0 g per day) secondary to a biopsy-proven 1 creatinine kinase, coagulation tests including fibrinogen were in the normal ranges. We 2 observed a low serum albumin (24.6 g/l), nephrotic range proteinuria (4.2 g/l -800 ml per 

Atypical HUS relapse triggered by 16 COVID-19

Kidney disease is associated with in-hospital death of 18 patients with COVID-19

A clinicopathologic study of thrombotic 20 microangiopathy in IgA Nephropathy

Emerging evidence of a COVID-19