期刊
CLINICAL KIDNEY JOURNAL
卷 -, 期 -, 页码 -出版社
OXFORD UNIV PRESS
DOI: 10.1093/ckj/sfad222
关键词
acute kidney injury; complement system; COVID-19; hantavirus; thrombotic microangiopathy
This study reports a case of severe hantavirus disease with coinciding SARS-CoV-2 infection, presenting as thrombotic microangiopathy with rapid response to eculizumab. These findings support a disease model involving virus-associated endothelial injury and complement activation.
The current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has refocused scientific interest on gaining insight into the pathophysiology of systemic viral diseases. Complement activation has been characterized as a driver of endothelial injury and microvascular thrombosis in acute respiratory distress syndrome as well as hantavirus hemorrhagic fever with renal syndrome. On this occasion, we wish to report a case of severe hantavirus disease with coinciding SARS-CoV-2 infection mimicking thrombotic microangiopathy with rapid response of inflammatory markers, hematologic parameters and proteinuria to eculizumab. These findings support a disease model of virus-associated endothelial injury involving alternative pathway complement activation. Future studies are needed to explore whether end organ damage can be mitigated by complement inhibition in life-threatening viral disease.
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