{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T04:14:37Z","timestamp":1768450477676,"version":"3.49.0"},"reference-count":40,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,3,31]],"date-time":"2021-03-31T00:00:00Z","timestamp":1617148800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>The renal involvement of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been reported. The etiology of kidney injury appears to be tubular, mainly due to the expression of angiotensin-converting enzyme 2, the key joint receptor for SARS-CoV-2; however, cases with glomerular implication have also been documented. The multifactorial origin of this renal involvement could include virus-mediated injury, cytokine storm, angiotensin II pathway activation, complement dysregulation, hyper-coagulation, and microangiopathy. We present the renal histological findings from a patient who developed acute kidney injury and de novo nephrotic syndrome, highly suggestive of acute IgA-dominant infection-associated glomerulonephritis (IgA-DIAGN) after SARS-CoV-2 infection, as evidenced by the presence of this virus detected in the renal tissue of the patient via immunohistochemistry assay. In summary, we document the first case of IgA-DIAGN associated to SARS-CoV-2. Thus, SARS-CoV-2 S may act as a super antigen driving the development of multisystem inflammatory syndrome as well as cytokine storm in patients affected by COVID-19, reaching the glomerulus and leading to the development of this novel IgA-DIAGN.<\/jats:p>","DOI":"10.3390\/v13040587","type":"journal-article","created":{"date-parts":[[2021,3,31]],"date-time":"2021-03-31T05:57:18Z","timestamp":1617170238000},"page":"587","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["IgA-Dominant Infection-Associated Glomerulonephritis Following SARS-CoV-2 Infection"],"prefix":"10.3390","volume":"13","author":[{"given":"Aurora","family":"P\u00e9rez","sequence":"first","affiliation":[{"name":"Nephrology Department, Hospital Cl\u00ednico Universitario, INCLIVA, Universidad de Valencia, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isidro","family":"Torregrosa","sequence":"additional","affiliation":[{"name":"Nephrology Department, Hospital Cl\u00ednico Universitario, INCLIVA, Universidad de Valencia, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0148-891X","authenticated-orcid":false,"given":"Luis","family":"D\u2019Marco","sequence":"additional","affiliation":[{"name":"Nephrology Department, Hospital Cl\u00ednico Universitario, INCLIVA, Universidad de Valencia, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel","family":"Juan","sequence":"additional","affiliation":[{"name":"Nephrology Department, Hospital Cl\u00ednico Universitario, INCLIVA, Universidad de Valencia, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liria","family":"Terradez","sequence":"additional","affiliation":[{"name":"Pathology Department, Hospital Cl\u00ednico Universitario, INCLIVA, Universidad de Valencia, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miguel \u00c1ngel","family":"Sol\u00eds","sequence":"additional","affiliation":[{"name":"Nephrology Department, Hospital Cl\u00ednico Universitario, INCLIVA, Universidad de Valencia, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1812-4098","authenticated-orcid":false,"given":"Francesc","family":"Moncho","sequence":"additional","affiliation":[{"name":"Nephrology Department, Hospital Cl\u00ednico Universitario, INCLIVA, Universidad de Valencia, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carmen","family":"Carda-Batalla","sequence":"additional","affiliation":[{"name":"Pathology Department, Hospital Cl\u00ednico Universitario, INCLIVA, Universidad de Valencia, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mar\u00eda J.","family":"Forner","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Hospital Cl\u00ednico Universitario, INCLIVA, Universidad de Valencia, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1134-9051","authenticated-orcid":false,"given":"Jose Luis","family":"Gorriz","sequence":"additional","affiliation":[{"name":"Nephrology Department, Hospital Cl\u00ednico Universitario, INCLIVA, Universidad de Valencia, 46010 Valencia, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,3,31]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.kint.2020.05.006","article-title":"Acute kidney injury in patients hospitalized with COVID-19","volume":"98","author":"Hirsch","year":"2020","journal-title":"Kidney Int."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"104833","DOI":"10.1016\/j.phrs.2020.104833","article-title":"Physiological and pathological regulation of ACE2, the SARS-CoV-2 receptor","volume":"157","author":"Li","year":"2020","journal-title":"Pharmacol. Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"228","DOI":"10.1016\/j.kint.2020.04.006","article-title":"Collapsing glomerulopathy in a COVID-19 patient","volume":"98","author":"Kissling","year":"2020","journal-title":"Kidney Int."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"940","DOI":"10.1016\/j.ekir.2020.04.017","article-title":"Acute Kidney Injury Due to Collapsing Glomerulopathy Following COVID-19 Infection","volume":"5","author":"Peleg","year":"2020","journal-title":"Kidney Int. Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"935","DOI":"10.1016\/j.ekir.2020.04.002","article-title":"Collapsing Glomerulopathy in a Patient With COVID-19","volume":"5","author":"Larsen","year":"2020","journal-title":"Kidney Int. Rep."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1959","DOI":"10.1681\/ASN.2020060802","article-title":"Kidney Biopsy Findings in Patients with COVID-19","volume":"31","author":"Kudose","year":"2020","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1380","DOI":"10.1681\/ASN.2020040419","article-title":"Acute Kidney Injury in COVID-19: Emerging Evidence of a Distinct Pathophysiology","volume":"31","author":"Batlle","year":"2020","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1093\/ckj\/sfaa104","article-title":"Coronavirus disease 2019 in chronic kidney disease","volume":"13","author":"Puchades","year":"2020","journal-title":"Clin. Kidney J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13000-020-01017-8","article-title":"Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and coronavirus disease 19 (COVID-19)\u2013anatomic pathology perspective on current knowledge","volume":"15","author":"Mohanty","year":"2020","journal-title":"Diagn. Pathol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"231","DOI":"10.2215\/CJN.08640811","article-title":"Renal Monoclonal Immunoglobulin Deposition Disease: A Report of 64 Patients from a Single Institution","volume":"7","author":"Nasr","year":"2011","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"480","DOI":"10.3109\/0886022X.2011.573895","article-title":"IgA-Dominant Postinfectious Glomerulonephritis: Not Peculiar to Staphylococcal Infection and Diabetic Patients","volume":"33","author":"Wen","year":"2011","journal-title":"Ren. Fail."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"98","DOI":"10.1159\/000377684","article-title":"Clinicopathologic Features of IgA-Dominant Infection-Associated Glomerulonephritis: A Pooled Analysis of 78 Cases","volume":"41","author":"Bu","year":"2015","journal-title":"Am. J. Nephrol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1093\/ckj\/sfu090","article-title":"Immune profile of IgA-dominant diffuse proliferative glomerulonephritis","volume":"7","author":"Wallace","year":"2014","journal-title":"Clin. Kidney J."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Guill\u00e9n, A.O.O., Silva, R.I.V., Gonz\u00e1lez, B.M., Guell, Y.A., Fossas, P.G., G\u00f3mez, I.G.C., Araujo, O.M., Abraham, V.S., Piccoli, G.B., and Madero, M. (2019). Acute IgA-Dominant Glomerulonephritis Associated with Syphilis Infection in a Pregnant Teenager: A New Disease Association. J. Clin. Med., 8.","DOI":"10.3390\/jcm8010114"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"105","DOI":"10.4132\/KoreanJPathol.2012.46.2.105","article-title":"Clinicopathologic Features of IgA-Dominant Postinfectious Glomerulonephritis","volume":"46","author":"Koo","year":"2012","journal-title":"Korean J. Pathol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1007\/s40620-016-0265-x","article-title":"IgA nephropathy and infections","volume":"29","author":"Rollino","year":"2016","journal-title":"J. Nephrol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1111\/j.1523-1755.2004.00714.x","article-title":"Staphylococcus aureus cell envelope antigen is a new candidate for the induction of IgA nephropathy","volume":"66","author":"Koyama","year":"2004","journal-title":"Kidney Int."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Fraser, J.D. (2011). Clarifying the Mechanism of Superantigen Toxicity. PLoS Biol., 9.","DOI":"10.1371\/journal.pbio.1001145"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"607","DOI":"10.2215\/CJN.07311009","article-title":"Treatment with IFN-\u03b1, -\u03b2, or -\u03b3 Is Associated with Collapsing Focal Segmental Glomerulosclerosis","volume":"5","author":"Markowitz","year":"2010","journal-title":"Clin. J. Am. Soc. Nephrol."},{"key":"ref_20","first-page":"109","article-title":"Broad spectrum of interferon-related nephropathies-glomerulonephritis, systemic lupus erythematosus-like syndrome and thrombotic microangiopathy: A case report and review of literature","volume":"8","author":"Gianassi","year":"2019","journal-title":"World J. Nephrol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"528","DOI":"10.1089\/vim.2004.17.528","article-title":"Structure-Based Preliminary Analysis of Immunity and Virulence of SARS Coronavirus","volume":"17","author":"Li","year":"2004","journal-title":"Viral Immunol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"829","DOI":"10.1016\/j.kint.2020.03.005","article-title":"Kidney disease is associated with in-hospital death of patients with COVID-19","volume":"97","author":"Cheng","year":"2020","journal-title":"Kidney Int."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1569","DOI":"10.1016\/S0140-6736(20)31022-9","article-title":"Remdesivir in adults with severe COVID-19: A randomised, double-blind, placebo-controlled, multicentre trial","volume":"395","author":"Wang","year":"2020","journal-title":"Lancet"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1016\/j.jinf.2020.05.009","article-title":"Acute kidney injury in hospitalized patients with coronavirus disease 2019 (COVID-19): A meta-analysis","volume":"81","author":"Ng","year":"2020","journal-title":"J. Infect."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.1007\/s11255-020-02451-9","article-title":"Chronic kidney disease is associated with severe coronavirus disease 2019 (COVID-19) infection","volume":"52","author":"Henry","year":"2020","journal-title":"Int. Urol. Nephrol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1948","DOI":"10.1681\/ASN.2020050699","article-title":"COVID-19\u2013Associated Kidney Injury: A Case Series of Kidney Biopsy Findings","volume":"31","author":"Sharma","year":"2020","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Ma, Y., Diao, B., Lv, X., Liang, W., Zhu, J., Liu, L., Zhang, S., Shen, B., and Wang, H. (2020). 2019 novel coronavirus disease in hemodialysis (HD) patients: Report from one HD center in Wu-han China. MedRxiv.","DOI":"10.1101\/2020.02.24.20027201"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1016\/S0140-6736(20)30937-5","article-title":"Endothelial cell infection and endotheliitis in COVID-19","volume":"395","author":"Varga","year":"2020","journal-title":"Lancet"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1683","DOI":"10.1681\/ASN.2020040432","article-title":"Ultrastructural Evidence for Direct Renal Infection with SARS-CoV-2","volume":"31","author":"Farkash","year":"2020","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1016\/j.ekir.2020.04.030","article-title":"COVID-19\u2013Associated Collapsing Glomerulopathy: An Emerging Entity","volume":"5","author":"Nasr","year":"2020","journal-title":"Kidney Int. Rep."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.kint.2020.04.003","article-title":"Renal histopathological analysis of 26 postmortem findings of patients with COVID-19 in China","volume":"98","author":"Su","year":"2020","journal-title":"Kidney Int."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1016\/j.kint.2020.05.012","article-title":"Electron microscopic investigations in COVID-19: Not all crowns are coronas","volume":"98","author":"Roufosse","year":"2020","journal-title":"Kidney Int."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2223","DOI":"10.1681\/ASN.2020050755","article-title":"Caution in Identifying Coronaviruses by Electron Microscopy","volume":"31","author":"Miller","year":"2020","journal-title":"J. Am. Soc. Nephrol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/S0140-6736(20)30183-5","article-title":"Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China","volume":"395","author":"Huang","year":"2020","journal-title":"Lancet"},{"key":"ref_35","first-page":"7","article-title":"Diabetic Kidney Disease and COVID-19: The Crash of Two Pandemics","volume":"7","author":"Puchades","year":"2020","journal-title":"Front. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1016\/j.immuni.2020.04.003","article-title":"COVID-19: A New Virus, but a Familiar Receptor and Cytokine Release Syndrome","volume":"52","author":"Hirano","year":"2020","journal-title":"Immunity"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Cheng, M.H., Zhang, S., Porritt, R.A., Arditi, M., and Bahar, I. (2020). An insertion unique to SARS-CoV-2 exhibits superantigenic character strengthened by recent mutations. BioRxiv.","DOI":"10.1101\/2020.05.21.109272"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1356","DOI":"10.1016\/j.kint.2018.01.005","article-title":"Interleukin-6 is essential for glomerular immunoglobulin A deposition and the development of renal pathology in Cd37-deficient mice","volume":"93","author":"Rops","year":"2018","journal-title":"Kidney Int."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Sardu, C., Gambardella, J., Morelli, M.B., Wang, X., Marfella, R., and Santulli, G. (2020). Hypertension, Thrombosis, Kidney Failure, and Diabetes: Is COVID-19 an Endothelial Disease? A Comprehensive Evaluation of Clinical and Basic Evidence. J. Clin. Med., 9.","DOI":"10.20944\/preprints202004.0204.v1"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2001526","DOI":"10.1183\/13993003.01526-2020","article-title":"Distinct features of SARS-CoV-2-specific IgA response in COVID-19 patients","volume":"56","author":"Yu","year":"2020","journal-title":"Eur. Respir. J."}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/13\/4\/587\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T14:10:34Z","timestamp":1760364634000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/13\/4\/587"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,31]]},"references-count":40,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,4]]}},"alternative-id":["v13040587"],"URL":"https:\/\/doi.org\/10.3390\/v13040587","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,31]]}}}