Nephrotic syndrome and vasculitis following SARS-CoV-2 vaccine: true association or circumstantial?

Izzedine, Hassan; Bonilla, Marco; Jhaveri, Kenar D.

doi:10.1093/ndt/gfab215

Cited by 42 publications

(44 citation statements)

References 32 publications

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“…Studies show that coronavirus vaccines are largely safe in underlying rheumatological disease. 1 There are rare cases being reported of de novo glomerulonephritis 2 and glomerulonephritis flares 3 after the coronavirus vaccine. Prior COVID illness is a risk for vasculitis flares after vaccination.…”

Section: Discussionmentioning

confidence: 99%

Lupus nephritis flare post Moderna mRNA-1273 coronavirus vaccine

Sekar

2021

QJM: An International Journal of Medicine

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Section: Discussionmentioning

confidence: 99%

Lupus nephritis flare post Moderna mRNA-1273 coronavirus vaccine

Sekar

2021

QJM: An International Journal of Medicine

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“…An increasing number of studies has also supported a possible link between COVID-19 vaccination and the rapid development of de novo or relapsed glomerular diseases, such as anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV). AAV is an autoimmune disorder characterized by small vascular inflammation, which predominantly occurs in the kidneys and in the presence of anti-neutrophil cytoplasmic antibodies and either anti-myeloperoxidase or anti-proteinase 3 antibodies ( 6 , 7 ). Here, we describe an elderly patient who developed life-threatening AAV and rapidly progressive glomerulonephritis (RPGN) and pulmonary hemorrhage 3 weeks after her first COVID-19 mRNA vaccination.…”

Section: Introductionmentioning

confidence: 99%

Case Report: Anti-neutrophil Cytoplasmic Antibody-Associated Vasculitis With Acute Renal Failure and Pulmonary Hemorrhage May Occur After COVID-19 Vaccination

Chen

et al. 2021

Front. Med.

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The rare and severe adverse effects associated with coronavirus disease of 2019 (COVID-19) vaccination have been under-appreciated, resulting in many instances of inappropriate management. We describe the case of an elderly woman who developed anti-neutrophil cytoplasmic antibody-associated vasculitis with pulmonary renal syndrome approximately 3 weeks after the first dose of COVID-19 mRNA vaccination (Moderna). Her nasopharyngeal polymerase chain reaction test for the COVID-19 RNA virus was negative. Gross hematuria, heavy proteinuria, acute renal failure (serum creatinine up to 6.5 mg/dL), and hemoptysis coupled with a marked increase in serum anti-myeloperoxidase-O antibody were observed. Renal biopsy showed severe vasculitis with pauci-immune crescent glomerulonephritis. The pulmonary hemorrhage was resolved and renal function improved following combined plasma exchange and the administration of systemic steroids and anti-CD20 therapy. The early examination of urinalysis and renal function may be crucial for identifying glomerulonephritis and acute renal failure in susceptible patients after COVID-19 vaccination.

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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%

“…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].…”

Section: Discussionmentioning

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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Nephrotic syndrome and vasculitis following SARS-CoV-2 vaccine: true association or circumstantial?

Cited by 42 publications

References 32 publications

Lupus nephritis flare post Moderna mRNA-1273 coronavirus vaccine

Lupus nephritis flare post Moderna mRNA-1273 coronavirus vaccine

Case Report: Anti-neutrophil Cytoplasmic Antibody-Associated Vasculitis With Acute Renal Failure and Pulmonary Hemorrhage May Occur After COVID-19 Vaccination

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

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