Is COVID-19 vaccination unmasking glomerulonephritis?

Tan, Hui Zhuan; Tan, Ru Yu; Choo, Jason Chon Jun; Lim, Cynthia Ciwei; Tan, Chieh Suai; Loh, Alwin Hwai Liang; Tien, Carolyn Shan-Yeu; Tan, Puay Hoon; Woo, Keng Thye

doi:10.1016/j.kint.2021.05.009

Cited by 79 publications

(79 citation statements)

References 2 publications

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“…To the editor: With great interest, we read the recent reports of IgA nephropathy (IgAN) flare-up presenting as macroscopic hematuria, following the second dose of coronavirus disease 2019 (COVID-19) vaccination in adult patients. [1][2][3][4] The US Food and Drug Administration granted an emergency use authorization for the Pfizer-BioNtech COVID-19 vaccination in December 2020 for individuals aged $16 years; the emergency use authorization was recently expanded to include children aged 12 to 15 years on May 10, 2021. Herein, we report 2 pediatric patients with IgAN presenting with macroscopic hematuria <24 hours after Pfizer COVID-19 vaccination.…”

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confidence: 99%

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IgA nephropathy presenting as macroscopic hematuria in 2 pediatric patients after receiving the Pfizer COVID-19 vaccine

Hanna

Hernandez

et al. 2021

Kidney International

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confidence: 99%

“…methylprednisolone daily Â3, followed by oral prednisone COVID-19 vaccine, and COVID-19 vaccination may unmask previously undiagnosed glomerulonephritis in pediatric patients. [1][2][3][4]…”

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confidence: 99%

IgA nephropathy presenting as macroscopic hematuria in 2 pediatric patients after receiving the Pfizer COVID-19 vaccine

Hanna

Hernandez

et al. 2021

Kidney International

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“…The timely editorial from Bomback et al on de novo and relapsing glomerular diseases after COVID-19 vaccination noted that immunoglobulin A nephropathy (IgAN) was one of the most frequently reported glomerulonephritides in this context 1 . However, the absolute incidence was low, with 10 reports of de novo or relapsed IgAN, including 1 from our institution 2 . Vaccine safety data in IgAN are lacking in part because immunosuppressed patients, including those with glomerular diseases, were generally excluded 3…”

Section: Covid-19 Vaccination In Immunoglobulin a Nephropathymentioning

confidence: 65%

COVID-19 Vaccination in Immunoglobulin A Nephropathy

Lim

Choo

Tan

2021

American Journal of Kidney Diseases

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Currently, there seems to be no direct evidence for causality linking vaccination and anti-GBM GN in any reports [ 8 – 10 ]. In the same way, links between centipede bites and anti-GBM GN have generally not been demonstrated.…”

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%

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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Is COVID-19 vaccination unmasking glomerulonephritis?

Cited by 79 publications

References 2 publications

IgA nephropathy presenting as macroscopic hematuria in 2 pediatric patients after receiving the Pfizer COVID-19 vaccine

IgA nephropathy presenting as macroscopic hematuria in 2 pediatric patients after receiving the Pfizer COVID-19 vaccine

COVID-19 Vaccination in Immunoglobulin A Nephropathy

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

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