Glucocorticoids Induce Partial Remission of Focal Segmental Glomerulosclerosis but Not Interstitial Nephritis in COVID-19 Acute Kidney Injury in an APOL1 Low-Risk Genotype White Patient

Piotr J. Nowak; Joanna Forycka; Natalia Cegielska; Karolina Harendarz; Małgorzata Wągrowska-Danilewicz; Marian Danilewicz; Tomasz Płoszaj; Maciej Borowiec; Rafał Wlazeł; Michał Nowicki

doi:10.12659/AJCR.933462

02 November 2021 : Case report Poland

Glucocorticoids Induce Partial Remission of Focal Segmental Glomerulosclerosis but Not Interstitial Nephritis in COVID-19 Acute Kidney Injury in an APOL1 Low-Risk Genotype White Patient

Challenging differential diagnosis, Rare coexistence of disease or pathology

Piotr J. Nowak^1ABCDEF*, Joanna Forycka^2BCEF, Natalia Cegielska^2BCEF, Karolina Harendarz^2BCEF, Małgorzata Wągrowska-Danilewicz^3BCD, Marian Danilewicz^4BCD, Tomasz Płoszaj^5BCD, Maciej Borowiec^5CDG, Rafał Wlazeł^6BCD, Michał Nowicki^1DEG

DOI: 10.12659/AJCR.933462

Am J Case Rep 2021; 22:e933462

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Table 1. Summary of blood laboratory evaluations and relevant trends during hospitalization.

Laboratory test	Reference	Hospital day
Laboratory test	Reference	1	2	3	4	5	6	11	17
Creatinine	<105 µmol/L	520	530	570	540	450	320	126	112
Urea	2.8–7.2 mmol/L	18.0	20.3	22.5	23.5	25.0	24.1	12.2	9.7
Potassium	3.5–5.1 mmol/L	4.1	4.2	5.2	4.5	5.0	4.5	4.3	4.7
Sodium	136–146 mmol/L	134	135	138	137	138	138	139	140
Chloride	101–109 mmol/L	99	101	102	104	107	107	109	112
Bicarbonates	22–26 mmol/L	20.8	20.9	20.8	22.6	23.9	24.9
Total calcium	2.2–2.65 mmol/L	1.75		1.8
Corrected calcium	2.2–2.65 mmol/L	2.2		2.3
Phosphates	0.81–1.45 mmol/L		1.5			1.6		1.7
pH	7.35–7.45	7.40	7.40	7.41	7.37	7.39	7.43
Plasma lactate acid	0.5–2.2 mmol/L	0.8		0.6
Albumin	35–55 g/L	22.5		19.3					18.3
Total protein	66–83 g/L		49.4	46.5
Total cholesterol	3–5 mmol/L			4.2					6.1
Triglycerides	<1.7 mmol/L								2.2
Glucose	4.1–5.5 mmol/L		4.6						4.5
Total bilirubin	5–21 µmol/L	4.0	4.4
ALP	30–12 U/L		35
ALT	<50 U/L		41
AST	<50 U/L	65	40
GGT	<55 U/L	52	43
CK	<171 U/L		130	107				33
Myoglobin	28–72 ng/mL				92
LDH	<248 U/L		510	560			415
D-dimer	<0.5 mg/L	0.7
Ferritin	30–400 ng/mL	3153
Fibrinogen	150–450 mg/dL	699		518
CRP	<5 mg/L	199	258	314	255	123	66	5	2
Procalcitonin	<0.5 µg/L	0.43	0.75	0.56				0.15	0.15
WBC	4–11×10/µL	11.5	11.7	13.0	8.5	8.7	9.7	11.4	9.9
Platelet count	15–40×10/µL	318	331	391	439	465	483	223	206
Hemoglobin	14–18 g/dL	15.3	13.9	14.2	13.7	13.2	13.4	12.5	11.1
Sars-CoV-2 rRT-PCR		Detected							Not detected
Anti-SARS-CoV-2 IgM									Detected
Anti-SARS-CoV-2 IgG									Detected
ALP – alkaline phosphatase; ALT – alanine transaminase; AST – aspartate transaminase; CK – creatine kinase; CRP – C-reactive protein; GGT – gamma-glutamyltransferase; IgM – immunoglobulin M; IgG – immunoglobulin G; LDH – lactate dehydrogenase; WBC – white blood cells; rRT-PCR – real-time reverse transcription polymerase chain reaction. ^* Calcium serum concentration corrected for hypoalbuminemia.

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Glucocorticoids Induce Partial Remission of Focal Segmental Glomerulosclerosis but Not Interstitial Nephritis in COVID-19 Acute Kidney Injury in an APOL1 Low-Risk Genotype White Patient

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