![]() ![]() There were 5 patients who presented after the second dose of the vaccine (range 2–6 weeks) and 3 patients who presented after the first dose (range 1–2 weeks). The clinical characteristics of these patients are found in Table 1. Of newly diagnosed cases (8 patients), there were 4 cases of IgAN, 1 case of MCD, 1 case of NELL-1–associated MN, 1 case of myeloperoxidase-antineutrophilic cytoplasmic Ab (ANCA) crescentic GN, and 1 case of atypical anti-GBM nephritis. ![]() Baseline clinical characteristics of each patient are found in Table 1.Ĭlinical Characteristics of Patients With Newly Diagnosed GNs Median serum creatinine level was 1.6 (0.6–2.5) mg/dl. AKI, edema, and macroscopic hematuria were common presentations. In contrast, all of our relapse cases occurred after the second dose with median onset of 3 weeks. Median time of onset in those newly diagnosed with having GN was 1 week after the first dose and 4 weeks after the second dose. Most patients presented after the second dose (10 of 13, 77%). In addition, 54% of our patients received mRNA-1273 (Moderna) and the other 46% received BNT162b2 (Pfizer) vaccine. The second most common GNs were MN (3 of 13, 23%) and primary podocytopathy (2 cases of minimal change disease and 1 case of primary FSGS) (3 of 13, 23%). IgAN was the most common GN in our case series (5 of 13, 38%). The autoimmune diseases included diabetes mellitus type 1, Crohn’s disease, ulcerative colitis, primary sclerosing cholangitis, and psoriatic arthritis. ![]() Autoimmune disease (38%) was the most common comorbidity in our series followed by cancer (23%). Most patients were White (12 of 13, 92%) and male (9 of 13, 69%). Of these, 8 of 13 cases (62%) were newly diagnosed with having GN whereas 5 of 13 cases (38%) were relapses. There were 13 patients reported in this case series. We also report on 3 new diagnoses after COVID-19 vaccination, including a case of NELL-1–associated MN, a case of primary FSGS, and a case of atypical anti-GBM nephritis.īaseline Demographic and Clinical Characteristics of Newly Diagnosed and Relapsed GNs We also provide evidence in 1 case of “new” IgAN wherein the deposits were present previously. In this case series, we report 13 cases of newly diagnosed or flares of GN post–COVID-19 mRNA vaccines and provide a literature review of all the reported GN cases thus far. But whether COVID-19 vaccine results in an immune response that triggers IgA antibody (Ab) production and formation of new deposits in the kidneys or whether the immune response to the vaccine only unmasks the presence of previously formed deposits is unclear. 15 The most common reported GN thus far is IgAN. 6, 7, 8, 9, 10, 11, 12, 13, 14 Nevertheless, rare cases of GN related to inactivated virus vaccine (CoronaVac from Sinovac) have also been reported. 4, 5 Most cases have been associated with mRNA vaccines (Pfizer and Moderna) and adenovirus vector deliveries. 1, 2 Since mass-scale vaccination, however, several immune-mediated reactions, including cases of myocarditis and newly diagnosed or relapsed GN, have been reported. 3 These vaccines thus far have been found to have excellent safety profile, and the most common immediate and short-term side effects for both mRNA vaccines have mostly involved injection site reaction. Once injected, the mRNA is translated into target protein resulting in robust immune response. 1, 2 mRNA vaccines use lipid nanoparticle as a vehicle to deliver genetically modified mRNA. The use of recently developed mRNA vaccine, such as BNT162b2 (Pfizer) and mRNA-1273 (Moderna), has provided effective protection against severe COVID-19 infection. Rapid and mass SARS-CoV-2 vaccination has been one of the pivotal strategies to curb the COVID-19 pandemic.
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