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  A Case of Rivaroxaban-Induced Acute Tubulointerstitial Nephritis

  Kali Gray and Kelly Mercier

  Publication Date: 5-9-2024

  Direct oral anticoagulants have garnered increasing popularity over the past several years and have largely replaced the use of warfarin in the treatment of certain conditions such as atrial fibrillation and the prevention and treatment of thromboembolism.

  Rivaroxaban is one of the most commonly used direct oral anticoagulants. It is 66% renally-cleared and a common side effect is renal impairment of which the pathophysiology has been unclear.

  There have been case reports of rivaroxaban-induced acute tubulointerstitial nephritis. Here we present an additional case of acute tubulointerstitial nephritis, most likely caused by rivaroxaban.

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  Minimal Change Disease Secondary to Either COVID-19 Infection or Pfizer-BioNTech COVID-19 Vaccination.

  Ashbita Pokharel, Wei Li, Hassan D. Kanaan, Ping L. Zhang, and Neal B. Blatt

  Publication Date: 9-2022

  Introduction/Objective

  Kidney injury has now become one of the known complications following COVID-19 infection and vaccination. Only few cases of minimal change disease following administration of COVID-19 vaccination and infection have been reported. This study was to highlight incidence of minimal change disease following COVID-19 infection or vaccination. Methods/Case Report

  Case 1:15 year-old female with past medical history of asthma and hypercholesterolemia presented for evaluation of periorbital edema, nephrotic-range proteinuria, hypoalbuminemia, elevated serum creatinine, elevated blood pressures, and hematuria after COVID-19 infection. Renal biopsy after 1 week of infection showed unremarkable glomeruli and negative immunofluorescent stains in glomeruli, and 20-30% fusion of foot processes. The biopsy was consistent with a minimal change disease with features of natural remission (her nephrotic-range proteinuria resolved soon after). Case 2: 18 year-old female with no significant past medical history presented with a chief complaint of generalized swelling, which started around the same time she received her 1st dose of Pfizer COVID vaccine (the 2nd dose 2 months later). She had a nephrotic range proteinuria and hypoalbuminemia, but normal level of serum creatinine. A renal biopsy after 4 months of vaccination showed unremarkable glomeruli by light microscopy, negative immunofluorescent study, but diffuse effacement of foot processes involving more than 80% of the examined loops by electron microscopy. This biopsy findings were consistent with a minimal change disease. Both patients did not receive any treatment before the renal biopsies. Results (if a Case Study enter NA)

  NA Conclusion

  Minimal change disease can be a rare complication following COVID-19 infection or Pfizer COVID-19 vaccination, raising a question if there are similar antigens induced by the infection or by the vaccination that trigger the minimal change disease. Further studies are needed to determine the incidence and pathophysiology of minimal change disease either post COVID-19 vaccines or following COVID-19 infections.

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  HIV-associated nephropathy presenting as the first manifestation of HIV 2 infection

  Kamil Sardarli, Rania Daboul Daboul, Sumesh Khanal, and Sami Zarouk

  Publication Date: 4-2022

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  Dual Paraneoplastic Syndrome in Small Cell Lung Cancer

  Kamil Sardarli, Austin Morris, and Jamal AbuKhaled

  Publication Date: 11-2022