{
  "abstract": "Multisystem inflammatory syndrome in adults (MIS-A) is a severe postinfectious complication of COVID-19. Renal involvement is common; however, histopathological findings have not been adequately characterised. We here report a case of a previously healthy man in his 60s who developed persistent fever, diarrhoea, glossitis and digital swelling approximately 3 weeks after COVID-19 infection. Antibiotic therapy was ineffective and renal function deteriorated. He was diagnosed with MIS-A and corticosteroid therapy produced marked clinical improvement. He was discharged 3 weeks after hospital admission. Renal biopsy demonstrated medullary haemorrhagic interstitial nephritis with preserved cortex, an uncommon pathological finding in renal injury secondary to COVID-19, which is consistent with possible immune-mediated endothelial injury.This case highlights medullary haemorrhagic interstitial nephritis as a potential pathological manifestation of MIS-A and illustrates a diagnostic pitfall. Recognition of MIS-A is essential for timely corticosteroid treatment and prevention of life-threatening multiorgan failure.",
  "authors": [
    {
      "affiliations": [
        "Nephrology, Daido Hospital, Nagoya, Japan"
      ],
      "name": "Hiroki Matsuoka"
    },
    {
      "affiliations": [
        "Nephrology, Daido Hospital, Nagoya, Japan"
      ],
      "name": "Hideaki Shimizu"
    },
    {
      "affiliations": [
        "Chiba Higashi Byoin, Chiba, Japan"
      ],
      "name": "Hiroshi Kitamura"
    },
    {
      "affiliations": [
        "Yao Tokushukai Sogo Byoin, Yao, Japan"
      ],
      "name": "Joel Branch"
    }
  ],
  "title": "Medullary haemorrhagic interstitial nephritis in multisystem inflammatory syndrome in adults following COVID-19",
  "uid": "08d52df8-43a3-53b6-8961-146f953afd07"
}