Relapse of IgG4-related nephritis following mRNA COVID-19 vaccine

Abstract

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A prospective observational study for justification, safety, and efficacy of a third dose of mRNA vaccine in patients receiving maintenance hemodialysis

“…Although, the safety of the 3D of BNT162b2 vaccine was excellent and comparable to that of the 2D with no critical local or systemic side-effect reported, the tolerance was worst in patients with already high humoral response, who did not improve significantly their immune response against the spike protein of SARS-Cov-2 after this additional injection. Furthermore, while not identified in our cohort, some cases of (re)activation of auto-immune disorders have been reported after mRNA vaccines in the literature 33 , 34 , 35 . This threat further supports avoiding useless additional vaccine injection in patient already protected after 2D.…”

Renal Thrombotic Microangiopathy in Concurrent COVID-19 Vaccination and Infection

“…The potential adverse effects of COVID-19 vaccines represent a hot topic of current research. Major side-effects appear to be uncommon, although some cases of new onset or relapsing minimal change disease [1][2][3], IgA nephropathy and anti-GBM glomerulonephritis [4] and relapse of IgG4related disease [5] have recently reported following the Pfizer-BioNTech vaccine. On the other hand, the kidney is one of the main targets of COVID-19 complications related to several mechanisms, including viral cytopathic effects in renal cells, host hyperinflammatory response and endothelial dysfunction.…”

Kidney complications following COVID-19 vaccination; a review of the literature

“…36 articles were identified including a total of 49 reported cases (Table 1). These included MCD (n = 17) (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25), IgA nephropathy (IgAN) (n = 15) (26)(27)(28)(29)(30)(31)(32)(33)(34), IgA nephritis/vasculitis (n = 5) (10,30,35,36), ANCA glomerulonephritis/vasculitis (n = 5) (7,8,35,37,38), anti-GBM nephritis (n = 2) (28, 39), 1 case of each granulomatous vasculitis (40), acute tubulointerstitial nephritis (ATIN) (41), scleroderma renal crisis (42), IgG4-related disease nephritis (43), and primary MN (11).…”

“…In addition, in patients with IgG4-RD, increased IgE and autoantibodies of the IgE isotype have been reported, although the exact association of IgE and IgG4-RD is still unclear (73). To our knowledge, there has only been one report of a relapse of IgG4-RD nephritis following COVID-19 vaccination (43).…”

“…Masset et al suggested that there is a possible link between the relapses of immune diseases following mRNA vaccinations. However, they argued that it is still unclear whether the relapses are due to a direct immune activation triggered by the vaccination, or due to a chronic immune activation triggered by an allergic reaction, or both of these (43). The pathogenesis and the association between IgG4-RD nephritis and COVID-19 mRNA vaccination require further investigation.…”