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Collapsing Focal Segmental Glomerulosclerosis and Acute Oxalate Nephropathy in a Patient With COVID-19: A Double Whammy
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Collapsing Focal Segmental Glomerulosclerosis and Acute Oxalate Nephropathy in a Patient With COVID-19: A Double Whammy
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Collapsing Focal Segmental Glomerulosclerosis and Acute Oxalate Nephropathy in a Patient With COVID-19: A Double Whammy
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Journal Article
Collapsing Focal Segmental Glomerulosclerosis and Acute Oxalate Nephropathy in a Patient With COVID-19: A Double Whammy
2020
Overview
As COVID-19 (coronavirus disease 2019) spreads across the world multiple therapeutic interventions have been tried to reduce morbidity and mortality. We describe a case of collapsing focal sclerosing glomerulosclerosis (FSGS) and acute oxalate nephropathy in a patient treated with high-dose intravenous vitamin C for severe COVID-19 infection. Collapsing FSGS has been described in patients with COVID-19 infection associated with APOL-1; however, this case had collapsing FSGS developing in low-risk heterozygous APOL-1 variant, and we postulate that the intensity of the COVID-19 cytokine storm overwhelmed the protective state of APOL-1 heterozygosity. This case illustrates the importance of assessing the risk and benefit of planned therapeutic interventions on a case-by-case basis especially when there are still so many unknowns in the management of COVID-19 infection. Strong consideration should be given for performing a renal biopsy in patients who develop multifactorial acute kidney injury.
Publisher
SAGE Publications,Sage Publications Ltd,SAGE Publishing
Subject
/ Acute Kidney Injury - diagnosis
/ Acute Kidney Injury - etiology
/ Ascorbic Acid - administration & dosage
/ Ascorbic Acid - adverse effects
/ Biopsy
/ Coronavirus Infections - drug therapy
/ Coronavirus Infections - epidemiology
/ COVID-19
/ Glomerulosclerosis, Focal Segmental - chemically induced
/ Glomerulosclerosis, Focal Segmental - diagnosis
/ Humans
/ Hyperoxaluria - chemically induced
/ Kidney Glomerulus - pathology
/ Male
/ Pneumonia, Viral - drug therapy
/ Pneumonia, Viral - epidemiology
