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Abstract: TH-PO738

COVID-19 Unmasking Concurrent IgA Nephropathy and Minimal Change Disease

Session Information

Category: Glomerular Diseases

  • 1403 Podocyte Biology


  • Roan, Rachel J., Temecula Valley Hospital, Temecula, California, United States
  • Lam, Jason Navarro, Temecula Valley Hospital, Temecula, California, United States
  • Chang, David, Temecula Valley Hospital, Temecula, California, United States

The existence of concurrences of Minimal Change Disease (MCD) and IgA nephropathy (IgAN) is exceedingly rare. This is an unusual case of COVID-19 unmasking a dual glomerulopathy of MCD and IgAN.

Case Description

54-year-old Asian female presented with flu-like symptoms, worsening anasarca, and bubbly urine. She was hemodynamically stable on room air. Exam was pertinent for lung crackles, edematous eyelids, and +2 lower extremities edema. Labs showed BUN 50mg/dL, creatinine (Cr) 2.9mg/dL, and albumin 0.8mg/dL. Baseline Cr was 0.61mg/dL. Urine analysis showed >300mg/dL proteins with large blood and dysmorphic RBC. A spot urine protein 5065.9 mg/dL and Cr 389 gm/dL. COVID-19 was positive. Glomerulonephritis panel was negative. Kidney biopsy under immunofluorescence microscopy showed diffuse segmental granular mesangial staining +2 IgA. Electron Microscopy showed extensive effacement of podocyte foot processes (> 90%) with dense deposits in the mesangium. Concurrence of IgAN and MCD was diagnosed and she was started on prednisone and lisinopril.


This highlights the rarity of the co-existence of two glomerular diseases with COVID-19. We postulate the likelihood that our patient had long-standing IgAN given the disease's indolent course, followed by the development of MCD from COVID-19 infections. There have been similar cases showing the concurrence of the two diseases, but there has been no report with COVID-19 infection. After treating the patient with steroids for total of 3 months, our patient was able to successfully remain in remission.

Foot process effacement

IgA immune deposits