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. 2023 Jun;103(6):1193-1198.
doi: 10.1016/j.kint.2023.02.028. Epub 2023 Mar 12.

Acute tubulointerstitial nephritis with or without uveitis: a novel form of post-acute COVID-19 syndrome in children

Marina Avramescu  1 , Pierre Isnard  2 , Sarah Temmam  3 , Agnès Chevalier  4 , Paul Bastard  5 , Mikael Attia  6 , Romain Berthaud  1 , Marc Fila  4 , Claire Dossier  7 , Julien Hogan  7 , Tim Ulinski  8 , Damia Leguevaques  9 , Férielle Louillet  10 , Edouard Martinez Casado  10 , Jean-Michel Halimi  11 , Sylvie Cloarec  12 , Ariane Zaloszyc  13 , Camille Faudeux  14 , Caroline Rousset-Rouvière  15 , Stéphanie Clavé  15 , Jérôme Harambat  16 , Edouard Rollot  16 , Thomas Simon  17 , Megan Nallet-Amate  18 , Bruno Ranchin  19 , Justine Bacchetta  19 , Florence Porcheret  20 , Josselin Bernard  20 , Amélie Ryckewaert  21 , Anne Jamet  22 , Jacques Fourgeaud  22 , Nicolas Da Rocha  3 , Philippe Pérot  3 , Nicolas Kuperwasser  23 , Naïm Bouazza  24 , Marion Rabant  25 , Jean-Paul Duong Van Huyen  25 , Matthieu P Robert  26 , Julien Zuber  27 , Jean-Laurent Casanova  28 , Marc Eloit  3 , Isabelle Sermet-Gaudelus  29 , Olivia Boyer  30
Affiliations

Acute tubulointerstitial nephritis with or without uveitis: a novel form of post-acute COVID-19 syndrome in children

Marina Avramescu et al. Kidney Int. 2023 Jun.
No abstract available

Keywords: COVID-19; SARS-CoV-2; TINUs; pediatric; tubule-interstitial nephritis; uveitis.

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Figures

None
Graphical abstract
Figure 1
Figure 1
Incidence of nationwide pediatric acute tubulointerstitial nephritis (aTIN)/aTIN with uveitis (TINUs) cases in France and anti–severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody levels and profiles in children with aTIN/TINUs. (a) Annual incidence of nationwide pediatric TINUs cases in France from 2000 to 2022. (b) Bimonthly incidence of nationwide pediatric aTIN/TINUs cases in France from April 2020 to November 2022. The approximate dates of circulation of the different strains of SARS-CoV-2 and the dates of launch of the vaccination campaigns according to age are shown in the figure. All analyzed cases of aTIN/TINUs were recorded during the circulation of the original virus and the Alpha variant. Interestingly, only 21 cases of aTIN/TINUs were later recorded between April 2021 and November 2022, when the Delta and the Omicron variants were the predominant viral strains. Of note, none of the patients had received any vaccination against SARS-CoV-2 before the diagnosis of aTIN/TINUs as the campaign for children aged >12 years was launched on June 15, 2021, in France. (Continued)
Figure 1
Figure 1
Incidence of nationwide pediatric acute tubulointerstitial nephritis (aTIN)/aTIN with uveitis (TINUs) cases in France and anti–severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody levels and profiles in children with aTIN/TINUs. (a) Annual incidence of nationwide pediatric TINUs cases in France from 2000 to 2022. (b) Bimonthly incidence of nationwide pediatric aTIN/TINUs cases in France from April 2020 to November 2022. The approximate dates of circulation of the different strains of SARS-CoV-2 and the dates of launch of the vaccination campaigns according to age are shown in the figure. All analyzed cases of aTIN/TINUs were recorded during the circulation of the original virus and the Alpha variant. Interestingly, only 21 cases of aTIN/TINUs were later recorded between April 2021 and November 2022, when the Delta and the Omicron variants were the predominant viral strains. Of note, none of the patients had received any vaccination against SARS-CoV-2 before the diagnosis of aTIN/TINUs as the campaign for children aged >12 years was launched on June 15, 2021, in France. (Continued)
Figure 2
Figure 2
Light microscopy and immunohistochemistry analysis of kidney biopsies. Representative images of optical microscopy. (a) Light microscopy (original magnification ×100) using periodic acid–Schiff staining, showing diffuse interstitial infiltrate mainly composed of mononuclear cells. (b) Light microscopy (original magnification ×400) using silver staining, showing numerous tubulitis lesions. (c) Immunohistochemistry analysis (original magnification ×100) targeting CD3, showing an important T-cell infiltrate. (d) Immunohistochemistry analysis (original magnification ×100) targeting CD68, showing an important macrophage infiltrate. (e,f) Immunohistochemistry analysis (original magnification ×100) targeting CD4 and CD8, showing a relatively balanced distribution of CD8 and CD4 T cells. (g) Immunohistochemistry analysis (original magnification ×100) targeting CD138, showing numerous plasma cells. (h) Immunohistochemistry analysis (original magnification ×100) targeting CD20, showing a small B-cell infiltrate. (i) Light microscopy (original magnification ×100) using periodic acid–Schiff staining, showing granulomas with multinucleated giant cells in a minority of patients. (j) Immunofluorescence analysis (original magnification ×100) targeting IgG, showing no tubular basal membrane deposits. Bar = 100 μm. To optimize viewing of this image, please see the online version of this article at www.kidney-international.org.
See this image and copyright information in PMC

References

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Supplementary concepts