A Patient with Cryoglobulinemic Membranoproliferative GN (MPGN) Who Survived COVID-19 Disease: Case Presentation and Current Data of COVID-19 Infection in Dialysis and Transplanted Patients in Greece

Marinaki, Smaragdi; Tsiakas, Stathis; Skalioti, Chrysanthi; Lourida, P; Argyraki, Aikaterini; Grigorakos, Konstantinos; Boletis, Ioannis

doi:10.3390/medicina56070355

Cited by 5 publications

(2 citation statements)

References 12 publications

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“…Although the immunopathogenesis of these disorders is not fully understood, many researchers have observed a link between infections and the development of primary GN [27][28][29]. Moreover, in a cohort of 20 patients with primary GN, we previously showed that the frequencies of PD-1-positive and PD-L1-positive T and B lymphocytes were higher among patients suffering from PGN than in those diagnosed with NPGN or in the control group [30].…”

Section: Introductionmentioning

confidence: 89%

PD-1 and PD-L1 Expression on Circulating Lymphocytes as a Marker of Epstein-Barr Virus Reactivation-Associated Proliferative Glomerulonephritis

Grywalska

Smarz-Widelska²,

Korona-Głowniak

et al. 2020

IJMS

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Alterations to the programmed cell death protein-1 (PD-1) pathway were previously shown to be involved in a poorer prognosis for patients with proliferative glomerulonephritis (PGN). Here, we investigated the association between several infectious agents and the expression of PD-1 and its ligand (PD-L1) on T and B lymphocytes in patients with PGN and nonproliferative glomerulonephritis (NPGN). A cohort of 45 newly-diagnosed patients (23 with PGN and 22 with NPGN) and 20 healthy volunteers was enrolled. The percentage of peripheral blood mononuclear cells expressing PD-1 and PD-L1 antigens was determined by flow cytometry. We found PD-1 and PD-L1 expression on T and B lymphocytes was higher in PGN patients than in NPGN patients and controls. We also found that reactivation of the Epstein-Barr virus (EBV) correlated with the expression of PD-1/PD-L1 antigens in patients with PGN. Further receiver operating characteristic analysis indicated that PD-1 expression could distinguish EBV-positive PGN patients from those with NPGN or healthy controls. The use of PD-1 expression as a non-invasive marker of PGN should be further investigated.

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Section: Introductionmentioning

confidence: 89%

PD-1 and PD-L1 Expression on Circulating Lymphocytes as a Marker of Epstein-Barr Virus Reactivation-Associated Proliferative Glomerulonephritis

Grywalska

Smarz-Widelska²,

Korona-Głowniak

et al. 2020

IJMS

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“…The available literature described cases with underlying glomerular pathology exacerbated during SARS-CoV2 infection, e.g., IgA nephropathy [74], cryoglobulinemic MPGN [75], and Membranous nephropathy [76].…”

Section: Chronic Kidney Diseasementioning

confidence: 99%

Kidneys in SARS‐CoV‐2 era: A challenge of multiple faces

et al. 2022

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Introduction: With the evolution of SARS-CoV-2 pandemic, it was believed to be a direct respiratory virus. But, its deleterious effects were observed on different body systems, including kidneys. Aim of Work: In this review, we tried as much as we can to summarize what has been discussed in the literature about the relation between SARS-CoV-2 infection and kidneys since December, 2019.Methods: Each part of the review was assigned to one or two authors to search for relevant articles in three databases (Pubmed, Scopus, and Google scholar) and collected data were summarized and revised by two independent researchers. Conclusion:The complexity of COVID-19 pandemic and kidney could be attributed to the direct effect of SARS-CoV-2 infection on the kidneys, different clinical presentation, difficulties confronting dialysis patients, restrictions of the organ transplant programs, poor outcomes and bad prognosis in patients with known history of kidney diseases who got infected with SARS-CoV-2.

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Immunosuppressants

2020

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Immunosuppressants COVID-19: case report A 62-year-old man developed COVID-19 following immunosuppressive treatment with rituximab, cyclophosphamide, prednisolone and methylprednisolone [not all routes stated]. The man, who had history of chronic lymphocytic leukaemia (CLL), was initially evaluated in Clinic for Nephrology and Renal Transplantation of Laiko Hospital of Athens, Greece, in July 2019 for nephrotic syndrome and impaired kidney function (Chronic Kidney Disease stage III). Based on kidney biopsy findings, he was diagnosed with cryoglobulinaemic glomerulonephritis. Therefore, he started receiving rituximab four weekly doses of 375 mg/m 2 , IV cyclophosphamide three monthly infusions of 500 mg/m 2 and prednisolone 0.75 mg/kg for 3 weeks, followed by a slow taper. The last infusion of cyclophosphamide was administered in October 2019 (total dose administered 3g). At last follow-up in February 2020, 6 months from the therapy initiation, creatinine and proteinuria levels were decreased, and he was receiving methylprednisolone 6 mg/day. On 16 March 2020, he presented to the emergency department with dry cough and high fever. He reported no travel history or contact with a coronavirusinfected patient. His symptoms had started 5 days prior to presentation and rapidly deteriorated on the day of admission. On physical examination he was tachypnoeic with oxygen saturation at 93%. The throat swab sample tested positive for SARS-CoV-2 (RT-PCR). He was then transferred to a referral hospital for COVID-19. A chest CT scan revealed diffuse bilateral infiltrates. He had stage IIb pneumonia with hypoxia. Along with respiratory support with oxygen therapy, the man started receiving off-label treatment with hydroxychloroquine 200mg twice daily and ceftriaxone. His clinical status deteriorated rapidly. Two days later, he was transferred to the ICU and put on mechanical ventilation due to respiratory failure. Off-label azithromycin 500mg once daily for 7 days was started in the ICU. Remdesivir was not administered because of renal impairment. He remained haemodynamically stable without vasopressors support and maintained a satisfactory urine output in spite of a transient renal function deterioration. His respiratory function gradually improved. After 7 days he was discharged from the ICU to the rehabilitation unit. Meanwhile, a CT scan performed on the 16th day of hospitalisation revealed a remarkable improvement in the lung lesions. After 25 days of hospitalisation, he was discharged home. Thereafter, he remained in a good clinical condition.

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A Patient with Cryoglobulinemic Membranoproliferative GN (MPGN) Who Survived COVID-19 Disease: Case Presentation and Current Data of COVID-19 Infection in Dialysis and Transplanted Patients in Greece

Cited by 5 publications

References 12 publications

PD-1 and PD-L1 Expression on Circulating Lymphocytes as a Marker of Epstein-Barr Virus Reactivation-Associated Proliferative Glomerulonephritis

PD-1 and PD-L1 Expression on Circulating Lymphocytes as a Marker of Epstein-Barr Virus Reactivation-Associated Proliferative Glomerulonephritis

Kidneys in SARS‐CoV‐2 era: A challenge of multiple faces

Immunosuppressants

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