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Idiopathic nephrotic syndrome relapse following COVID-19 vaccination: a series of 25 cases.
Hummel, Aurélie; Oniszczuk, Julie; Kervella, Delphine; Charbit, Marina; Guerrot, Dominique; Testa, Angelo; Philipponnet, Carole; Chauvet, Cécile; Guincestre, Thomas; Brochard, Karine; Benezech, Ariane; Figueres, Lucile; Belenfant, Xavier; Guarnieri, Andrea; Demoulin, Nathalie; Benetti, Elisa; Miglinas, Marius; Dessaix, Kathleen; Morelle, Johann; Angeletti, Andrea; Sellier-Leclerc, Anne-Laure; Ranchin, Bruno; Goussard, Guillaume; Hudier, Laurent; Bacchetta, Justine; Servais, Aude; Audard, Vincent.
  • Hummel A; Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Universitaire Necker-Enfants Malades, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare "Syndrome Néphrotique Idiopathique" (SNI), Paris, France.
  • Oniszczuk J; AP-HP, Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare SNI, Créteil, France.
  • Kervella D; Institut de Transplantation Urologie Néphrologie, Centre Hospitalo Universitaire (CHU) Nantes, Nantes, France.
  • Charbit M; AP-HP, Hôpital Universitaire Necker-Enfants Malades, Service de Néphrologie Pédiatrique, Centre de Référence MARHEA, Centre de Référence SNI, Institut Imagine, Université de Paris, Paris, France.
  • Guerrot D; Department of Nephrology, Hemodialysis and Transplantation, Rouen University Hospital, Rouen, France.
  • Testa A; Expansion Centre Hémodialyse de l'Ouest, Rezé, France.
  • Philipponnet C; Service Nephrologie Dialyse et Transplantation Rénale CHU de Clermont-Ferrand, Clermont-Ferrand, France.
  • Chauvet C; Service de Néphrologie, Centre Hospitalier Saint Joseph Saint Luc, Lyon, France.
  • Guincestre T; Service de Néphrologie, Centre Hospitalier de Roubaix, Roubaix, France.
  • Brochard K; Service de Néphrologie-Rhumatologie-Médecine Interne pédiatrique, Centre de Référence des Maladies Rénales Rares du Sud-Ouest, Hôpital des Enfants, Toulouse, France.
  • Benezech A; Service de Néphrologie-Rhumatologie-Médecine Interne pédiatrique, Centre de Référence des Maladies Rénales Rares du Sud-Ouest, Hôpital des Enfants, Toulouse, France.
  • Figueres L; Institut de Transplantation Urologie Néphrologie, Centre Hospitalo Universitaire (CHU) Nantes, Nantes, France.
  • Belenfant X; Groupe Hospitalier Grand Paris Nord Est, Hôpital André Grégoire, Service de Néphrologie-Dialyse, Montreuil, France.
  • Guarnieri A; Nephrology Dialysis and Transplant Unit, Azienda Ospedaliero-Universitaria Senese, Siena, Italy.
  • Demoulin N; Nephrology Division, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
  • Benetti E; Pediatric Nephrology, Dialysis and Transplant Unit, Department of Women's and Children's Health, Padua University Hospital, Padua, Italy.
  • Miglinas M; Nephrology Center, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
  • Dessaix K; Université de Montpellier, Service de Nephrologie, CHU Montpellier, Hôpital Lapeyronie, Montpellier, France.
  • Morelle J; Nephrology Division, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
  • Angeletti A; Division of Nephrology, Dialysis, Transplantation, IRCCS Giannini Gaslini Children's Hospital, Genova, Italy.
  • Sellier-Leclerc AL; Centre de Référence des Maladies Rénales Rares Néphrogones, Service de Néphrologie Rhumatologie et Dermatologie Pédiatriques, Hôpital Femme Mère Enfant, Faculté de Médecine Lyon Est, Bron, France.
  • Ranchin B; Centre de Référence des Maladies Rénales Rares Néphrogones, Service de Néphrologie Rhumatologie et Dermatologie Pédiatriques, Hôpital Femme Mère Enfant, Faculté de Médecine Lyon Est, Bron, France.
  • Goussard G; Service de Néphrologie et Transplantation CHU Poitiers, Poitiers, France.
  • Hudier L; Service de Néphrologie, Centre Hospitalier Broussais, Saint Malo, France.
  • Bacchetta J; Centre de Référence des Maladies Rénales Rares Néphrogones, Service de Néphrologie Rhumatologie et Dermatologie Pédiatriques, Hôpital Femme Mère Enfant, Faculté de Médecine Lyon Est, Bron, France.
  • Servais A; Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Universitaire Necker-Enfants Malades, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare "Syndrome Néphrotique Idiopathique" (SNI), Paris, France.
  • Audard V; AP-HP, Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Centre de Référence Maladie Rare SNI, Créteil, France.
Clin Kidney J ; 15(8): 1574-1582, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1883008
ABSTRACT

Background:

Several cases of idiopathic nephrotic syndrome (INS) relapse following the administration of coronavirus disease 2019 (COVID-19) vaccines have recently been reported, raising questions about the potential relationship between the immune response to COVID-19 vaccination and INS pathogenesis.

Methods:

We performed a retrospective multicentre survey describing the clinical and biological characteristics of patients presenting a relapse of INS after COVID-19 vaccination, with an assessment of outcome under treatment.

Results:

We identified 25 patients (16 men and 9 women) presenting a relapse within 1 month of a COVID-19 vaccine injection. The glomerular disease was of childhood onset in half of the patients and most patients (21/25) had received at least one immunosuppressive drug in addition to steroids for frequently relapsing or steroid-dependent nephrotic syndrome (NS). All patients were in a stable condition at the time of injection and 11 had no specific treatment. In five patients, the last relapse was reported >5 years before vaccine injection. The Pfizer-BioNTech (BNT162b2) vaccine was used in 80% of the patients. In 18 cases, INS relapse occurred after the first injection, a mean of 17.5 days after vaccination. A second injection was nevertheless administered in 14 of these patients. Five relapses occurred after administration of the second dose and two relapses after the administration of the third dose. All but one of the patients received steroids as first-line treatment, with an additional immunosuppressive agent in nine cases. During follow-up, complete remission was achieved in 21 patients, within 1 month in 17 cases. Only one patient had not achieved at least partial remission after 3 months of follow-up.

Conclusions:

This case series suggests that, in rare patients, COVID-19 vaccination may trigger INS relapse that is generally easy to control. These findings should encourage physicians to persuade their patients to complete the COVID-19 vaccination schedule.
Keywords

Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Topics: Vaccines Language: English Journal: Clin Kidney J Year: 2022 Document Type: Article Affiliation country: Ckj

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Full text: Available Collection: International databases Database: MEDLINE Type of study: Cohort study / Observational study / Prognostic study Topics: Vaccines Language: English Journal: Clin Kidney J Year: 2022 Document Type: Article Affiliation country: Ckj