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Front Immunol ; 12: 762006, 2021.
Article in English | MEDLINE | ID: covidwho-1477832


As the coronavirus disease 2019 (COVID-19) pandemic is ongoing and new variants of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) are emerging, there is an urgent need for COVID-19 vaccines to control disease outbreaks by herd immunity. Surveillance of rare safety issues related to these vaccines is progressing, since more granular data emerge with regard to adverse events of COVID-19 vaccines during post-marketing surveillance. Interestingly, four cases of anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) presenting with pauci-immune crescentic glomerulonephritis (GN) after COVID-19 mRNA vaccination have already been reported. We here expand our current knowledge of this rare but important association and report a case of AAV presenting with massive rhabdomyolysis and pauci-immune crescentic GN after Pfizer-BioNTech COVID-19 mRNA vaccination. As huge vaccination programs are ongoing worldwide, post-marketing surveillance systems must continue to assess vaccine safety important for the detection of any events associated with COVID-19 vaccination. This is especially relevant in complex diseases where diagnosis is often challenging, as in our patient with AAV presenting with massive rhabdomyolysis and pauci-immune crescentic GN.

Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/pathology , COVID-19 Vaccines/adverse effects , Glomerulonephritis/pathology , Rhabdomyolysis/pathology , Aged , Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/diagnosis , Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/immunology , Antibodies, Antineutrophil Cytoplasmic/blood , Antibodies, Antineutrophil Cytoplasmic/immunology , COVID-19/prevention & control , COVID-19 Vaccines/immunology , Female , Glomerulonephritis/diagnosis , Glomerulonephritis/immunology , Humans , RNA, Messenger/immunology , Rhabdomyolysis/diagnosis , Rhabdomyolysis/immunology
BMJ Case Rep ; 14(6)2021 Jun 15.
Article in English | MEDLINE | ID: covidwho-1270884


We present a case of antineutrophil cytoplasmic antibodies (ANCA)-associated rapidly progressive glomerulonephritis in the context of treatment of pulmonary tuberculosis (TB). A 42-year-old woman was treated for drug-susceptible pulmonary TB and represented with paradoxical worsening of symptoms and radiological features. She was HIV negative. A severe acute kidney injury with features of glomerulonephritis was evident on admission. Perinuclear ANCA and antimyeloperoxidase antibodies were present in serum and renal biopsy was consistent with ANCA-associated vasculitis. The patient was successfully treated with both antituberculous therapy and immunosuppression (corticosteroids and mycophenolate mofetil) with subsequent clinical improvement and amelioration of renal function. We propose this is the first case that describes the association between paradoxical reactions during TB treatment and ANCA-associated glomerulonephritis.

Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis , Glomerulonephritis , Tuberculosis , Adult , Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/complications , Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/diagnosis , Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis/drug therapy , Antibodies, Antineutrophil Cytoplasmic , Female , Glomerulonephritis/complications , Glomerulonephritis/diagnosis , Glomerulonephritis/drug therapy , Humans , Peroxidase
Iran J Kidney Dis ; 14(3): 239-242, 2020 05.
Article in English | MEDLINE | ID: covidwho-170320


During the COVID-19 pandemic, we had a 25 years old male case without any underlying disease or history of autoimmune disease in COVID-19 Clinic, Isfahan, Iran. He presented with arthralgia and weakness so we started COVID-19 therapeutic regimen. In his hospitalization, creatinine increases and abnormalities in random urine sediment was seen. Methylprednisolone and cyclophosphamide were prescribed due to suspected glomerulonephritis. After renal biopsy the diagnose was confirmed as crescentic proliferative glomerulonephritis. The patient also, underwent plasmapheresis and intravenous immunoglobulin injection. He was discharged healthy without development of new pulmonary symptoms despite immunosuppressive treatment.

Coronavirus Infections/complications , Glomerulonephritis/complications , Glomerulonephritis/diagnosis , Pneumonia, Viral/complications , Administration, Intravenous , Adult , Biopsy , COVID-19 , Coronavirus Infections/diagnosis , Cyclophosphamide/therapeutic use , Glomerulonephritis/drug therapy , Glomerulonephritis/surgery , Humans , Immunoglobulins/administration & dosage , Male , Methylprednisolone/therapeutic use , Pandemics , Pneumonia, Viral/diagnosis , Treatment Outcome