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 2. Summary of urine laboratory evaluations during hospitalization.

Laboratory test	Reference	Hospital day
Laboratory test	Reference	1	2	12	17	18
24-hour proteinuria	<0.15 g/day			22.6		26.5
ACR	<10 mg/g		1982		4100
Urinalysis
Appearance	Clear	Hazy	Hazy		Clear
Bilirubin	Negative	Negative	Negative		Negative
Blood	Negative	+	Negative		+
Color	Colorless, straw, yellow, pale yellow	Yellow	Yellow		Pale yellow
Glucose	Negative	Negative	Negative		Negative
Ketones	Negative	Negative	Negative		Negative
Leukocyte esterase	Negative	Negative	Negative		Negative
Nitrate	Negative	Negative	Negative		Negative
pH	4.5–8.0	5.0	5.0		6.0
Protein	Negative	10.2 g/L	9.5 g/L		4.9 g/L
Specific gravity	1.005–1.030 g/mL	1.020	1.020		1.016
Urobilinogen	<17 µmol/L	<17	< 17		<17
Urine sediment
Amorphous crystals	None seen, rare, occasional/HPF	None seen	Rare		None seen
Bacteria	None seen, rare/HPF	Rare	Rare		Rare
Casts	None seen/LPF	Rare: coarse granular, and hyline granular; Occasional: fine granular	Occasional: fine granular and hyline granular		Occasional, hyline casts
Mucus	None seen/LPF	Rare	Rare		Rare
RBC	0–2/HPF	Occasional	1–2		1–3
Renal epithelial cells	None seen/HPF	Rare	Occasional		None seen
Squamous epithelial cells	0–20/LPF	15	Occasional		Occasional
WBC	0–5/HPF	10–15	1–3		1–2
Yeast	None seen/HPF	None seen	None seen		None seen
ACR – albumin/creatinine ratio; HPF – high-power field; LPF – low-power field; RBC – red blood cells; WBC – white blood cells.

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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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