New-onset pediatric nephrotic syndrome following Pfizer-BioNTech SARS-CoV-2 vaccination: a case report and literature review

Nakazawa, Eriko; Uchimura, Toru; Hirai, Yuji; Togashi, Hayato; Oyama, Yoshitaka; Inaba, Aya; Shiga, Kentaro; Ito, Shuichi

doi:10.1007/s13730-021-00656-0

Cited by 21 publications

(14 citation statements)

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“…After vaccination, three patients (7.5%) suffered from a relapse of nephrotic syndrome, and two showed transient proteinuria after vaccination, which recovered spontaneously. Previous case reports have mentioned that a relapse of nephrotic syndrome might occur after SARS-CoV-2 mRNA vaccination [ 19 , 20 ]. Relapse of nephrotic syndrome in the 6 months prior to vaccination might be a risk factor of relapse after vaccination, although further evaluation is warranted for confirmation.…”

Section: Discussionmentioning

confidence: 99%

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Immunogenicity and safety of SARS-CoV-2 mRNA vaccine in patients with nephrotic syndrome receiving immunosuppressive agents

et al. 2022

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Background As there are no large-scale reports of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) mRNA vaccination in patients with nephrotic syndrome using immunosuppressive agents, we conducted the prospective study. Methods SARS-CoV-2 mRNA vaccines were administered to patients with nephrotic syndrome receiving immunosuppressive agents. The titers of SARS-CoV-2 spike protein receptor–binding domain antibodies were measured before and after vaccination. We evaluated factors associated with antibody titers after vaccination and analyzed adverse events. Results We enrolled 40 patients and evaluated vaccine immunogenicity in 35 of them. Seroconversion (> 0.8 U/mL) was achieved in all patients, and the median antibody titer was 598 U/mL (interquartile range, 89–1380 U/mL). Patients using mycophenolate mofetil (MMF) showed lower antibody titers than those who were not (median: 272 U/mL vs. 2660 U/mL, p = 0.0002), and serum immunoglobulin G (IgG) levels showed a weak linear relationship with antibody titers ( R 2 = 0.16). No breakthrough infections were noted. Three patients (7.5%) suffered from a relapse of nephrotic syndrome (2 and 3 days, respectively, after the first dose and 8 days after the second dose), two of whom had a history of relapse within 6 months before the vaccination. Conclusions The SARS-CoV-2 mRNA vaccine was immunogenic in patients with nephrotic syndrome using immunosuppressive agents, although the use of MMF and low levels of serum IgG were associated with lower antibody titers after vaccination. Patients with high disease activity may experience a relapse of nephrotic syndrome after vaccination. Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information Supplementary Information The online version contains supplementary material available at 10.1007/s00467-022-05633-y.

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Section: Discussionmentioning

confidence: 99%

“…Third, adverse events after vaccination, such as the relapse of nephrotic syndrome, must be examined. Although relapses of nephrotic syndrome were reported after SARS-CoV-2 mRNA vaccination [ 19 , 20 ], its incidence is unknown.…”

Section: Introductionmentioning

confidence: 99%

Immunogenicity and safety of SARS-CoV-2 mRNA vaccine in patients with nephrotic syndrome receiving immunosuppressive agents

et al. 2022

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“…A 15-year-old boy had no underlying diseases and he developed eyelid oedema four days after vaccination, with peripheral oedema of the lower extremities four days later. Treatment involved 60 mg of oral daily prednisolone, and complete remission was achieved within 12 days with no residual complications (eg, hypertension or acute kidney injury) [ 188 ].…”

Section: Possible Side Effects Of Covid-19 Vaccines In Children and Young Peoplementioning

confidence: 99%

The COVID-19 pandemic in children and young people during 2020-2021: A complex discussion on vaccination

et al. 2021

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“…Although serious adverse effects of COVID-19 vaccines are rare, it is important to continue to monitor its safety. The only other published pediatric case described a patient with steroid-sensitive nephrotic syndrome and stable kidney function following mRNA COVID-19 vaccination [3]. As MCD related to the SARS-CoV-2 BNT162b2 vaccine often develops within the first week of vaccination, the strong temporal association suggests that the T-cell mediated immune response to the SARS-CoV-2 BNT162b2 vaccine could be a potential trigger for podocytopathy [2,3].…”

mentioning

confidence: 99%

“…The only other published pediatric case described a patient with steroid-sensitive nephrotic syndrome and stable kidney function following mRNA COVID-19 vaccination [3]. As MCD related to the SARS-CoV-2 BNT162b2 vaccine often develops within the first week of vaccination, the strong temporal association suggests that the T-cell mediated immune response to the SARS-CoV-2 BNT162b2 vaccine could be a potential trigger for podocytopathy [2,3]. Our case provides additional support for a possible association between the SARS-CoV-2 BNT162b2 vaccine and pediatric kidney disease.…”

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Minimal change disease and acute interstitial nephritis following SARS-CoV-2 BNT162b2 vaccination

Jongvilaikasem

Rianthavorn

2022

Pediatr Nephrol

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New-onset pediatric nephrotic syndrome following Pfizer-BioNTech SARS-CoV-2 vaccination: a case report and literature review

Cited by 21 publications

References 23 publications

Immunogenicity and safety of SARS-CoV-2 mRNA vaccine in patients with nephrotic syndrome receiving immunosuppressive agents

Immunogenicity and safety of SARS-CoV-2 mRNA vaccine in patients with nephrotic syndrome receiving immunosuppressive agents

The COVID-19 pandemic in children and young people during 2020-2021: A complex discussion on vaccination

Minimal change disease and acute interstitial nephritis following SARS-CoV-2 BNT162b2 vaccination

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