Case of recurrent refractory nephrotic syndrome in a Japanese boy with COVID‐19

• Published in: Pediatric investigation Vol. 64; no. 1; pp. e14862 - n/a
• Main Authors: Watanabe, Yoshitaka, Watanabe, Tsuneki, Ikeda, Hirokazu
• Format: Journal Article Web Resource
• Language: English
• Published: Australia John Wiley & Sons, Inc 01.01.2022; Blackwell Publishing Ltd
• Subjects: Anticoagulants; Blood; COVID-19; Humans; Infections; Japan; Kidney diseases; Male; mycophenolate mofetil; Mycophenolic Acid; Nephrotic syndrome; Nephrotic Syndrome - diagnosis; Patients; Pediatrics; Proteins; Recurrence; Remission (Medicine); SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Taste disorders; Thrombosis; Japan; COVID-19; recurrence; SARS-CoV-2; mycophenolate mofetil; nephrotic syndrome
• ISSN: 1328-8067; 2096-3726; 1442-200X; 2574-2272
• DOI: 10.1111/ped.14862

On admission, his height was 166.4 cm, body weight 52.1 kg (no weight gain), temperature 36.7°C, heart rate 122 beats/min, respiratory rate 18 breaths/min, blood pressure 122/64 mmHg, and oxygen saturation of peripheral artery, 97%–99% (on room air). Hematological values included a white blood cell count of 10 040/μL with 73.0% neutrophils, hemoglobin count of 16.0 g/dL (slightly elevated), and a platelet count of 237 000/µL. Blood chemistry and serologic findings showed slightly decreased total protein levels (6.4 g/dL), albumin (3.8 g/dL), and immunoglobulin G (514 mg/dL). Additionally, Levi et al. reported that SARS-CoV-2 infection promotes severe systemic disease, which accompanies coagulation abnormalities.5 In this study, the SARS-CoV-2 infection possibly triggered the recurrence of refractory NS with hemoconcentration, which caused coagulation abnormalities. [...]intravenous heparin was selected since the antithrombin III level was maintained, and immediate anticoagulation was required.