Acute tubulointerstitial nephritis with or without uveitis: a novel form of post-acute COVID-19 syndrome in children

Marina Avramescu (1, 2) , Pierre Isnard (3, 4) , Sarah Temmam (5) , Agnès Chevalier (6) , Paul Bastard (7, 3, 8) , Mikael Attia (9) , Romain Berthaud (1, 2) , Marc Fila (6) , Claire Dossier (10) , Julien Hogan (10) , Tim Ulinski (11) , Damia Leguevaques (12) , Férielle Louillet (13) , Edouard Martinez Casado (13) , Jean-Michel Halimi (14) , Sylvie Cloarec (14) , Ariane Zaloszyc (15) , Camille Faudeux (16) , Caroline Rousset-Rouvière (17) , Stéphanie Clavé (17) , Jérôme Harambat (18, 19) , Edouard Rollot (18) , Thomas Simon (20) , Megan Nallet-Amate (21) , Bruno Ranchin (22) , Justine Bacchetta (22) , Florence Porcheret (23) , Josselin Bernard (23) , Amélie Ryckewaert (24) , Anne Jamet (3) , Jacques Fourgeaud (3) , Nicolas da Rocha (5) , Philippe Pérot (5) , Nicolas Kuperwasser (4) , Naïm Bouazza (25, 26, 27) , Marion Rabant (3) , Jean-Paul Duong van Huyen (3) , Matthieu Robert (3, 28) , Julien Zuber (3, 28) , Jean-Laurent Casanova (7, 8) , Marc Eloit (5) , Isabelle Sermet-Gaudelus (3) , Olivia Boyer (1, 2)

1 MARHEA - Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte [CHU-Necker]
2 Imagine - U1163 - Imagine - Institut des maladies génétiques (IHU)
3 CHU Necker - Enfants Malades [AP-HP]
4 INEM - UM 111 (UMR 8253 / U1151) - Institut Necker Enfants-Malades
5 Découverte de pathogènes – Pathogen discovery
6 Hôpital Arnaud de Villeneuve [CHRU Montpellier]
7 Equipe Inserm U1163 - Human genetics of infectious diseases : Mendelian predisposition
8 Rockefeller University [New York]
9 GMV-ARN (UMR_3569 / U-Pasteur_2) - Génétique Moléculaire des Virus à ARN - Molecular Genetics of RNA Viruses
10 AP-HP Hôpital universitaire Robert-Debré [Paris]
11 CHU Trousseau [APHP]
12 CHRU Lille - Centre Hospitalier Régional Universitaire [Lille]
13 CHU Rouen
14 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
15 CHU Strasbourg
16 CHU Nice - Centre Hospitalier Universitaire de Nice
17 APHM - Assistance Publique - Hôpitaux de Marseille
18 CHU Bordeaux [Bordeaux]
19 BPH - Bordeaux population health
20 CHU Toulouse - Centre Hospitalier Universitaire de Toulouse
21 CHU Dijon
22 HCL - Hospices Civils de Lyon
23 CHU Nantes - Centre hospitalier universitaire de Nantes
24 CHU Pontchaillou [Rennes]
25 URP_7323 - Pharmacologie et évaluations thérapeutiques chez l'enfant et la femme enceinte
26 Site Tarnier (hôpital Cochin) - APHP
27 CIC 1419 - CIC - Mère Enfant Necker Cochin Paris Centre
28 UPCité - Université Paris Cité

Multiorgan sequelae of coronavirus disease 2019 (COVID-19) beyond the acute phase of infection are increasingly described as clinical experience expands. In children, acute COVID-19 appears to be generally asymptomatic or mild. Yet, the multisystem inflammatory syndrome in children (MIS-C) may be a severe postinfectious complication following exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).1 During the first pandemic year, we observed a striking increase in the incidence of acute tubulointerstitial nephritis (aTIN) without or with uveitis (TINUs) among children. Causes of aTIN include drugs, infections, and systemic diseases, but often remain undetermined. The rare TINUs syndrome associating aTIN and uveitis is considered to result from a still ill-characterized immune-mediated process. The observed increased incidence of idiopathic aTIN/TINUs prompted us to examine whether SARS-CoV-2 might be the initial trigger.

Keywords: COVID-19; pediatric; SARS-CoV-; 2 TINUs; tubule-interstitial nephritis; uveitis

Domains: Life Sciences [q-bio]

Marina Avramescu, Pierre Isnard, Sarah Temmam, Agnès Chevalier, Paul Bastard, et al.. Acute tubulointerstitial nephritis with or without uveitis: a novel form of post-acute COVID-19 syndrome in children. Kidney International, 2023, in press. ⟨10.1016/j.kint.2023.02.028⟩. ⟨pasteur-04048764⟩