Collapsing Glomerulopathy and Nephrectomy in the Aftermath of COVID-19. Case Report
Abstract:
Collapsing glomerulopathy (CG) is a rare podocytopathy characterized by segmental collapse of the glomerulus with hypertrophy and hyperplasia of podocytes. Some cases have been reported in the aftermath of coronavirus disease 2019 (COVID-19). We present the case of a previously healthy 46-year-old Hispanic male who developed hypertensive urgency and macroscopic hematuria 15 days after mild COVID-19 infection. Right nephrectomy was performed due to suspected malignancy, but pathology reported nephrocalcinosis and moderate chronic interstitial nephritis. Two years later, the patient presented with subnephrotic proteinuria and chronic kidney disease, leading to a percutaneous renal biopsy, which confirmed CG with significant interstitial fibrosis and glomerulosclerosis. A retroperitoneal hematoma, a complication reported in <5–10% of kidney biopsies, developed post-biopsy and was managed with embolization. CG was presumed to be secondary to COVID-19 and nephrectomy. Treatment with methylprednisolone was ineffective, and the patient is currently on renal replacement therapy with peritoneal dialysis. This case adds to the limited reports of CG following COVID-19, highlighting potential long-term renal complications post-infection.
