Anti-GBM nephritis with mesangial IgA deposits after SARS-CoV-2 mRNA vaccination

Sacker, Allan; Kung, Vanderlene L.; Andeen, Nicole K.

doi:10.1016/j.kint.2021.06.006

Cited by 52 publications

(53 citation statements)

References 3 publications

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“…Both renal and skin symptoms resolved with a week course of oral prednisolone 40 mg daily. Two cases of anti-GBM disease have been reported following COVID-19 vaccination [25,38]. One patient presented a day after the second dose of the Pfizer-BioNTech vaccination with macroscopic hematuria and the other presented two weeks after the second dose of the Moderna vaccination with systemic illness (fever, anorexia, and nausea) and gross hematuria.…”

Section: Vasculitismentioning

confidence: 99%

New-Onset and Relapsed Kidney Histopathology Following COVID-19 Vaccination: A Systematic Review

Kalra

Chinnadurai

2021

Vaccines

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Introduction: The introduction of COVID-19 vaccination programs has become an integral part of the major strategy to reduce COVID-19 numbers worldwide. New-onset and relapsed kidney histopathology have been reported following COVID-19 vaccination, sparking debate on whether there are causal associations. How these vaccines achieve an immune response to COVID-19 and the mechanism that this triggers kidney pathology remains unestablished. We describe the results of a systematic review for new-onset and relapsed kidney histopathology following COVID-19 vaccination. Methods: A systematic literature search of published data up until 31 August 2021 was completed through the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guideline. Research articles reporting new onset or relapsed kidney histopathology in adult patients (>18 years) following COVID-19 vaccination were included for qualitative review. Only full-text articles published in the English language were selected for review. Results: Forty-eight cases from thirty-six articles were included in the qualitative synthesis of this systematic review. Minimal change disease (19 cases) was the most frequent pathology observed, followed by IgA nephropathy (14 cases) and vasculitis (10 cases). Other cases include relapse of membranous nephropathy, acute rejection of kidney transplant, relapse of IgG4 nephritis, new-onset renal thrombotic microangiopathy, and scleroderma renal crisis following COVID-19 vaccination. There was no mortality reported in any of the included cases. Patients in all but one case largely recovered and did not require long-term renal replacement therapy. Conclusion: This systematic review provides insight into the relationship between various kidney pathologies that may have followed COVID-19 vaccination. Despite these reported cases, the protective benefits offered by COVID-19 vaccination far outweigh its risks. It would be recommended to consider early biopsy to identify histopathology amongst patients presenting with symptoms relating to new-onset kidney disease following vaccination and to monitor symptoms for those with potential relapsed disease.

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Section: Vasculitismentioning

confidence: 99%

New-Onset and Relapsed Kidney Histopathology Following COVID-19 Vaccination: A Systematic Review

Kalra

Chinnadurai

2021

Vaccines

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“…Recently, a few cases have been reported of patients developing either anti-GBM nephritis or ANCA-mediated nephritis following vaccinations with either the Pfizer-BioNTech and Moderna SARS-CoV-2 mRNA vaccines. 1 , 2 We describe a rare case of concurrent anti-GBM and ANCA-mediated glomerulonephritis following COVID-19 vaccination with the second dose of the Moderna vaccine.…”

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confidence: 99%

Concurrent Antiglomerular Basement Membrane Nephritis and Antineutrophil Cytoplasmic Autoantibody–Mediated Glomerulonephritis After Second Dose of SARS-CoV-2 mRNA Vaccination

Gupta

Ellis

2022

Kidney International Reports

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“…In the same way, links between centipede bites and anti-GBM GN have generally not been demonstrated. In two reported cases of anti-GBM crescentic GN following COVID-19 vaccination, one developed a day after the second dose [ 8 ] and the other 2 weeks after the second dose [ 9 ]. This time course, from a day to 2 weeks, but not hours, implies the involvement of delayed-type hypersensitivity in the development of GN.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, there seems to be no direct evidence for causality linking vaccination and anti-GBM GN in any reports [8][9][10]. In the same way, links between centipede bites and anti-GBM GN COVID-19 vaccination, one developed a day after the second dose [8] and the other 2 weeks after the second dose [9]. This time course, from a day to 2 weeks, but not hours, implies the involvement of delayed-type hypersensitivity in the development of GN.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, some reports suggested the possibility of gross macroscopic hematuria occurring following COVID-19 vaccination in patients with known IgA nephropathy [ 6 , 7 ]. Subsequently, there were two case reports of healthy individuals who presented with macroscopic hematuria shortly after COVID-19 vaccinations and were diagnosed with anti-GBM GN [ 8 , 9 ]. Neither of them provides clear evidence of causality, but COVID-19 infection or other infectious complications that have the potential to trigger anti-GBM GN were ruled out.…”

Section: Introductionmentioning

confidence: 99%

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A case of anti-GBM nephritis following centipede bites and COVID-19 vaccination

2021

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A case of newly developed anti-glomerular basement membrane (GBM) glomerulonephritis (GN) following centipede bites and COVID-19 vaccination is presented. A 70-year-old woman presented for investigation of mild fever, generalized fatigue, and macroscopic hematuria with no past history of renal disease. One year earlier, she had been bitten by a centipede. Based on the governmental policy, she was given the first COVID-19 vaccination, and the second injection was planned 3 weeks later. Accidentally, she was again bitten by a centipede, and the injured site had swollen severely. Based on a physician’s judgment, the interval between vaccinations was extended to 8 weeks. One week after the second vaccination, macroscopic hematuria occurred suddenly, coincident with mild fever. Her serum anti-GBM titer was above the upper limit. There was no pulmonary involvement. Renal pathology showed anti-GBM GN, and she was treated with corticosteroid pulse therapy followed by sequential plasmapheresis. She had advanced renal dysfunction, but was independent of dialysis therapy during the one month of the remission induction therapy phase, and she is being treated with immunosuppressant therapy. Both vaccination and animal bites skew towards Th1 immunity, a key mechanism involved in the development of necrotizing GN evoked by anti-GBM antibody. Though there is no direct evidence for causality linking centipede bites, vaccination, and anti-GBM GN, the risk of anti-GBM GN appears to be increased by excessively induced Th1 immunity.

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Anti-GBM nephritis with mesangial IgA deposits after SARS-CoV-2 mRNA vaccination

Cited by 52 publications

References 3 publications

New-Onset and Relapsed Kidney Histopathology Following COVID-19 Vaccination: A Systematic Review

New-Onset and Relapsed Kidney Histopathology Following COVID-19 Vaccination: A Systematic Review

Concurrent Antiglomerular Basement Membrane Nephritis and Antineutrophil Cytoplasmic Autoantibody–Mediated Glomerulonephritis After Second Dose of SARS-CoV-2 mRNA Vaccination

A case of anti-GBM nephritis following centipede bites and COVID-19 vaccination

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