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Case Report
Glomerular capillary tuft collapse and podocytopathic changes in a newborn with congenital Zika virus syndrome
1 Laboratory of Experimental Pathology, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
2 Division of Nephrology, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
3 Laboratory of Molecular Virology, Instituto Carlos Chagas/Fiocruz PR, Curitiba, Paraná, Brazil
4 Department of Pathology, Universidade Federal do Paraná, Curitiba, Paraná, Brazil
Address correspondence to:
Sandra Mara Witkowski
Laboratory of Experimental Pathology, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná,
Brazil
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Article ID: 101174Z01SW2020
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Witkowski SM, Pecoits-Filho R, dos Santos CND, Soares MFS, Zanluca C, Azevedo MLV, de Noronha L. Glomerular capillary tuft collapse and podocytopathic changes in a newborn with congenital Zika virus syndrome. Int J Case Rep Images 2020;11:101174Z01SW2020.ABSTRACT
Introduction: In early 2015, several patients presenting with dengue-like symptoms were described in Brazil′s northeast region. Reverse transcription polymerase chain reaction (RT-PCR) results from patients′ sera revealed the Zika virus (ZIKV) infection. In parallel, an unusually high incidence of microcephaly in newborns was observed in the same region. Zika virus infection can induce microcephaly and congenital abnormalities.
Case Report: A male newborn (9 months of gestation, cesarean delivery) died within 20 hours. The mother had a confirmed viral infection in the third month of pregnancy. This report describes a case of ZIKV intrauterine infection associated with histologic alterations in the newborn kidney tissue. Immunohistochemistry, RNA extraction, and real-time RT-PCR were performed for the confirmation of ZIKV infection in tissues. Kidney samples were stained using conventional hematoxylin-eosin (H&E), methenamine silver, and periodic acid-Schiff with diastase digestion techniques. Analysis of brain tissue revealed severely affected gray and white matter sites of neuronophagy, gliosis, and calcium microdeposits. Immunohistochemistry (4G2 and specific anti-ZIKV monoclonal antibodies) showed diffusely distributed immunopositivity in glial cells. Aspects compatible with a focal segmental glomerular capillary tuft collapse associated with podocytopathic features with pseudo-crescent formation were observed in the kidney tissue.
Conclusion: This case suggests the ability of congenitally acquired ZIKV to produce alterations in renal cells and describes histological details of kidney involvement.
Keywords: Kidney glomerulus, Newborn, Podocytes, Zika virus
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Author Contributions
Sandra Mara Witkowski - Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Roberto Pecoits-Filho - Conception of the work, Design of the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Claudia Nunes Duarte dos Santos - Acquisition of data, Analysis of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Maria Fernanda S Soares - Acquisition of data, Analysis of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Camila Zanluca - Acquisition of data, Analysis of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Marina Luize Viola Azevedo - Acquisition of data, Analysis of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Lucia de Noronha - Conception of the work, Design of the work, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest
Copyright© 2020 Sandra Mara Witkowski et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
