Gross hematuria following vaccination for severe acute respiratory syndrome coronavirus 2 in 2 patients with IgA nephropathy

Histologic correlates of gross hematuria following Moderna COVID-19 vaccine in patients with IgA nephropathy

“…Anticoagulation with warfarin in 1 case may have potentiated the development of gross hematuria. The history of prior microhematuria, as noted in other reported cases, 1 , 2 , 3 and the presence of focal glomerular and tubulointerstitial scarring in both biopsies support the notion that immune response to vaccination exacerbated a preexisting IgA nephropathy. The rapid development of gross hematuria within several days of the second vaccination implicates a systemic cytokine-mediated flare, possibly via induction of heightened IgA1 anti-glycan immune responses.…”

“…We read with interest the recent reports of gross hematuria occurring in 4 patients with IgA nephropathy shortly following the second dose of mRNA vaccine for coronavirus disease 2019 (COVID-19). 1 , 2 , 3 These include 2 cases following the Moderna vaccine 1 and 2 following the Pfizer BioNTech vaccine. 2 , 3 As only 1 of these patients had a postvaccination biopsy performed, 3 we report the biopsy findings in 2 additional patients who underwent their first kidney biopsy due to the development of gross hematuria shortly following the second dose of the Moderna vaccine for COVID-19.…”

Minimal change disease following vaccination for SARS-CoV-2

“…To the best of our knowledge, very rare cases of biopsy-proven relapsing glomerulonephritis following COVID-19 vaccination have been previously reported including a paper by Rovin et al who described two cases of known IgA nephropathy showing gross hematuria following the second dose of the Moderna vaccine [ 5 ].…”

De Novo and Relapsing Glomerular Diseases After COVID-19 Vaccination: What Do We Know So Far?

“…2 At the time of this writing, these cases join at least sixteen other reports of kidney diseases arising within three weeks of COVID-19 vaccination, with most cases arising within the first week ( Table 1 ). These reports include 26 patients with a variety of lesions – MCD (n=10), 3 , 4 , 5 , 6 , 7 , 8 , 9 IgA nephropathy (n=10), 2 , 10 , 11 , 12 , 13 , 14 anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (n=2), 10 , 15 anti-glomerular basement membrane (anti-GBM) disease (n=2), 14 , 16 membranous glomerulopathy (n=1), 17 and IgG4-related disease (n=1). 18 Most reported cases have been associated with mRNA vaccines (either Pfizer BioNTech or Moderna) with the onset of glomerular disease occurring after the first or second dose.…”