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COVID-19 Vaccination and Glomerulonephritis.
Klomjit, Nattawat; Alexander, Mariam Priya; Fervenza, Fernando C; Zoghby, Ziad; Garg, Arvind; Hogan, Marie C; Nasr, Samih H; Minshar, Marwan Abu; Zand, Ladan.
  • Klomjit N; Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.
  • Alexander MP; Division of Nephrology and Hypertension, University of Minnesota, Minneapolis, Minnesota, USA.
  • Fervenza FC; Department of Pathology and Laboratory Medicine, Mayo Clinic, Rochester, Minnesota, USA.
  • Zoghby Z; Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.
  • Garg A; Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.
  • Hogan MC; Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.
  • Nasr SH; Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.
  • Minshar MA; Department of Pathology and Laboratory Medicine, Mayo Clinic, Rochester, Minnesota, USA.
  • Zand L; Division of Nephrology and Hypertension, Essentia Health, Fargo, North Dakota, USA.
Kidney Int Rep ; 6(12): 2969-2978, 2021 Dec.
Article in English | MEDLINE | ID: covidwho-1527657
ABSTRACT

INTRODUCTION:

mRNA COVID-19 vaccine is more effective than traditional vaccines owing to superior immune activation. Nevertheless, the impact of mRNA COVID-19 vaccine on triggering de novo/relapsing glomerulonephritis (GN) is limited. We report a case series of patients who developed new or relapsing GN postvaccination.

METHODS:

We evaluated baseline characteristics, vaccine type, and clinical outcomes of 13 patients from our institution who had a new diagnosis or relapse of their GN post-mRNA COVID-19 vaccination.

RESULTS:

Of 13 patients, 8 patients were newly diagnosed with having GN and 5 patients had relapse. Median age was 62 years (range 19-83 years). Autoimmune disease (38%) was the most prevalent underlying disease followed by cancer (23%). Most patients were White males. IgA nephropathy (IgAN) was the most common GN in our series (5 patients, 38%) followed by membranous nephropathy (MN) (3 patients, 23%). There was 1 patient with IgAN who had evidence of IgA deposits before vaccination suggesting the immune activation after vaccination triggered a flare of the disease. Our case series also included the first case report of tip-variant focal segmental glomerulosclerosis (FSGS), NELL-1-associated MN, and atypical anti-glomerular basement membrane (GBM) nephritis. A total of 77% developed acute kidney injury (AKI) with most being Kidney Disease Improving Global Outcomes stage 1 (67%). Outcomes are favorable with 80% responding to therapy.

CONCLUSION:

New cases and relapse of GN can present shortly after mRNA COVID-19 vaccination. New cases of IgAN may result from unmasking of undiagnosed IgAN owing to robust immune activation rather than development of new deposits.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Prognostic study Topics: Vaccines / Variants Language: English Journal: Kidney Int Rep Year: 2021 Document Type: Article Affiliation country: J.ekir.2021.09.008

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Experimental Studies / Prognostic study Topics: Vaccines / Variants Language: English Journal: Kidney Int Rep Year: 2021 Document Type: Article Affiliation country: J.ekir.2021.09.008