LAUSR

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 Sandra Mara Witkowski1, MD, Roberto Pecoits-Filho2, PhD, Claudia Nunes Duarte dos Santos3, PhD, Maria Fernanda S Soares4, PhD, Camila Zanluca3, PhD, Marina Luize Viola Azevedo1, MD, Lucia de Noronha1, MD, PhD Affiliations: 1Laboratory of Experimental Pathology, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil; 2Division of Nephrology, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil; 3Laboratory of Molecular Virology, Instituto Carlos Chagas/Fiocruz PR, Curitiba, Paraná, Brazil; 4Department of Pathology, Universidade Federal do Paraná, Curitiba, Paraná, Brazil. Corresponding Author: Sandra Mara Witkowski, Laboratory of Experimental Pathology, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil; Email: [email protected] Received: 04 August 2020 Accepted: 07 October 2020 Published: 05 November 2020 (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 pseudocrescent 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.