Post‐infectious acute glomerulonephritis with podocytopathy induced by parvovirus B19 infection

Abstract

Human parvovirus B19 infection causes a variety of glomerular diseases such as post-infectious acute glomerulonephritis and collapsing glomerulopathy. Although each of these appears independently, it has not been fully determined why parvovirus B19 provokes such a variety of different glomerular phenotypes. Here, we report a 68-year-old Japanese man who showed endocapillary proliferative glomerulonephritis admixed with podocytopathy in association with parvovirus B19 infection. The patient showed acute onset of heavy proteinuria, microscopic hematuria and kidney dysfunction with arthralgia and oliguria after close contact with a person suffering from erythema infectiosum. In the kidney biopsy specimen, glomeruli revealed diffuse and global endocapillary infiltration of inflammatory cells, with some also showing tuft collapse with aberrant vacuolation, swelling, and hyperplasia of glomerular epithelial cells. Immunofluorescence revealed dense granular C3 deposition that resembled the "starry sky pattern". Intravenous glucocorticoid pulse therapy followed by oral prednisolone and cyclosporine combination therapy resulted in considerable amelioration of the kidney dysfunction and urinary abnormalities. The present case reveals that parvovirus B19 infection can induce different glomerular phenotypes even in the same kidney structure. This finding may provide hints useful for the further elucidation of the pathogenesis of parvovirus B19-induced glomerular lesions.

Multicenter Clinicopathologic Correlation of Kidney Biopsies Performed in COVID-19 Patients Presenting With Acute Kidney Injury or Proteinuria

“…Infection-related glomerulonephritis is most commonly associated with bacterial infections but has been seen in association with viral infections, such as Parvovirus B19 and influenza virus H1N1. [35][36][37] Our patient manifested kidney symptoms 19 days after testing positive for SARS-CoV-2, indicating that the timing of glomerulonephritis fits with the pathogenesis of post-infectious glomerulonephritis. However, this patient also had nodular diabetic nephropathy and a concurrent urinary tract infection (UTI), and it is possible that the UTI was a cause of, or contributor to, the infection-related glomerulonephritis.…”

Prevention of parvovirus B19‐induced repetitive acute kidney failure by subcutaneous immunoglobulins

“…Spontaneous recovery was common within 2–28 weeks, a few patients having persistent renal dysfunction or proteinuria. Among these 33 patients, three had proven cryoglobulinemia . However, PVB19‐associated MPGN has rarely been described.…”