{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T21:40:40Z","timestamp":1768081240105,"version":"3.49.0"},"reference-count":17,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,3,27]],"date-time":"2021-03-27T00:00:00Z","timestamp":1616803200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Transplantation"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The negative impact of COVID\u201019 on adults with underlying chronic kidney disease, including kidney transplant recipients, has been well documented. Children have a less severe presentation and better prognosis compared to adults. However, little is known regarding the spectrum of COVID\u201019 infection in children and adolescents with underlying autoimmune disorders necessitating solid organ transplant and long\u2010term immunosuppressive therapy. Case Report. An adolescent male developed end\u2010stage kidney disease secondary to microscopic polyangiitis requiring a living\u2010donor kidney transplant. Six years later, he developed antibody\u2010mediated rejection of his kidney transplant. During his rejection treatment course, he contracted SARS\u2010CoV\u20102 and developed new\u2010onset nephrotic syndrome with severe acute kidney injury. Kidney transplant biopsy revealed de novo collapsing focal segmental glomerulosclerosis on a background of chronic active antibody mediated rejection. Immunostaining for SARS\u2010CoV\u20102 on the biopsy specimen demonstrated positive staining of the proximal tubular epithelium consistent with intra\u2010renal viral infection. Pulse corticosteroids, intravenous immunoglobulin, and temporary reduction of anti\u2010metabolite therapy resulted in successful recovery with return of graft function back to pre\u2010infection baseline. This case highlights the clinical conundrum of treating kidney transplant recipients with active rejection in the midst of the COVID\u201019 pandemic. Pediatric kidney transplant recipients can develop severe COVID\u201019\u2010related kidney complications. Judicious immunosuppression modulation is necessary to balance infection and rejection risk.<\/jats:p>","DOI":"10.1111\/petr.14013","type":"journal-article","created":{"date-parts":[[2021,3,27]],"date-time":"2021-03-27T11:58:42Z","timestamp":1616846322000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["De novo collapsing glomerulopathy in a pediatric kidney transplant recipient with COVID\u201019 infection"],"prefix":"10.1111","volume":"25","author":[{"given":"Emma","family":"Levenson","sequence":"first","affiliation":[{"name":"Department of Pediatrics LSU Health New Orleans New Orleans LA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tara N.","family":"Shepherd","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Tulane University School of Medicine New Orleans LA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diego","family":"Aviles","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Pediatrics LSU Health New Orleans New Orleans LA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Randall","family":"Craver","sequence":"additional","affiliation":[{"name":"Department of Pathology LSU Health Science Center New Orleans LA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdulla","family":"Ehlayel","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Pediatrics Children's Hospital New Orleans LA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gordon L.","family":"Love","sequence":"additional","affiliation":[{"name":"Department of Pathology LSU Health Science Center New Orleans LA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K'Joy","family":"Simms","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Pediatrics Children's Hospital New Orleans LA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caroline","family":"Straatmann","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Pediatrics LSU Health New Orleans New Orleans LA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0539-4021","authenticated-orcid":false,"given":"Isa F.","family":"Ashoor","sequence":"additional","affiliation":[{"name":"Division of Nephrology Department of Pediatrics LSU Health New Orleans New Orleans LA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2021,3,27]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2020.05.006"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.15891"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.15270"},{"key":"e_1_2_7_5_1","unstructured":"CDC.Demographic Trends of COVID\u201019. 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