CD40LG and acute kidney injury: Verschuuren et al. reported a case with fulminant HEV who developed a nonoliguric acute renal failure, and acute tubular necrosis probably due to the direct effect of HEV, since the renal biopsy of this patient showed no vascular abnormalities, and immune-fluorescence for IgA, IgG, IgM, heavy chains, k and l chains, and complement C3 was negative, suggesting that the renal impairment was not immune-mediated [46].