Child Kidney Dis.  2021 Dec;25(2):122-127. 10.3339/jkspn.2021.25.2.122.

Acute Respiratory Distress Syndrome after Rotavirus Infection in a C1q Nephropathy Patient: A Case Report

• Kim HJ
• Min J
• Kim JH
• Choi YH
• Han MS
• Ha IS
• Kang HG

• KMID: 2524514
• DOI: http://doi.org/10.3339/jkspn.2021.25.2.122

Abstract

C1q nephropathy is a rare glomerulopathy that typically presents with nephrotic syndrome in children. Treatment with immunosuppressive agents renders patients vulnerable to infection and its complications. Gastroenteritis is common in children, and rotavirus is a leading cause. Extraintestinal manifestations of rotavirus have recently been reported; however, there is a paucity of cases exploring the involvement of a rotavirus on the respiratory system. Acute respiratory distress syndrome (ARDS) is a rapid onset respiratory failure characterized by noncardiogenic pulmonary edema and hypoxemia. Causes of ARDS include sepsis, pneumonia, pancreatitis, aspiration, and trauma. In this paper, we report a case of ARDS after rotavirus infection in a child with C1q nephropathy who had been treated with immunosuppressive agents.

Keyword

Acute respiratory distress syndrome; Complement C1q; Glomerulonephritis; Rotavirus infections

Figure

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  Fig. 1. Kidney biopsy findings of the patient. (A) Light microscopy examination (Periodic acid-Schiff stain, x400) showed segmental glomerulosclerosis. (B) Immunofluorescence microscopy (x200) revealed dominant staining (3+) for C1q in the mesangium and periphery. (C) Electron microscopy showed electron-dense deposits in the mesangium and subendothelium.

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  Fig. 2. Radiographic findings. (A) Chest X-ray on admission showed no remarkable findings. (B) Chest X-ray taken 24 hours post-admission revealed rapidly progressive bilateral consolidation. (C) Chest X-ray on ICU admission showed increased pulmonary infiltrations and bilateral pleural effusion.

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  Fig. 3. Chest CT showing bilateral symmetric consolidation and ground glass opacity with bilateral pleural effusion (right>left).

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  Fig. 4. Chest X-ray on discharge showing resolution of previous lung lesion.

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