A case of acute interstitial nephritis following the Pfizer–BioNTech COVID-19 vaccine

Merino, José Carlos de la Flor; Grávalos, Tania Linares; Alonso-Riaño, Marina; Cebollada, Pilar Segura; Serra, Cristina Albarracin; Cicero, Elisa Ruiz; Bayas, Gioconda Gallegos; Pozoa, Miguel Rodeles del

doi:10.1016/j.nefroe.2021.05.007

Cited by 7 publications

(7 citation statements)

References 10 publications

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“…To our knowledge, this was the first described case of acute tubulointerstitial nephritis following administration of the Oxford-AstraZeneca COVID-19 vaccine. One case of tubulointerstitial nephritis was reported after the administration of the Pfizer-BioNTech vaccine in a patient with pre-existing chronic kidney disease [9]. However, the patient in this case was a 78-year-old man with multiple comorbidities including hypertension and diabetes with nephropathy.…”

Section: Discussionmentioning

confidence: 88%

A case of acute tubulointerstitial nephritis following administration of the Oxford-AstraZeneca COVID-19 vaccine: a case report

et al. 2023

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Background More than 4 billion doses of the Coronavirus disease (COVID-19) vaccine have been administered worldwide but the relationship between the different vaccines and the development of renal disease is unknown. We present a case of tubulointerstitial nephritis following administration of the Oxford-AstraZeneca COVID-19 vaccine. Case presentation A previously fit and well 51-year-old female presented on 27th May 2021 with a one-month history of weight loss, fatigue, nausea, and a metallic taste. She had an acute kidney injury with a creatinine of 484 umol/L. She was on no regular medications and denied taking any over-the-counter or alternative medicines. She had received her first dose of the Oxford-AstraZeneca vaccine on 23rd March 2021 and her second dose on 20th May 2021. A renal biopsy was performed the following day. The 19 glomeruli appeared normal to light microscopy but the tubulointerstitial compartment contained a dense inflammatory infiltrate including many eosinophils. There was widespread acute tubular injury with tubulitis, but no established or longstanding atrophy. A diagnosis was made of an acute tubulointerstitial nephritis. She was commenced on oral prednisolone and her renal function improved. She did not require renal replacement therapy at any time. Conclusions To our knowledge, this was the first described case of acute tubulointerstitial nephritis following administration of the Oxford-AstraZeneca COVID-19 vaccine, although a number of cases have emerged more recently. In our case the patient was very fit and well, had no previous past medical history and had not taken any recent prescribed, over-the-counter or alternative medications. The absence of these provoking factors in our case makes the vaccine the most likely explanation for the development of tubulointerstitial nephritis although the pathophysiology behind this remains unknown. Given the unprecedented number of vaccinations being delivered around the world, nephrologists should be aware of this possible link although more research into the topic is required.

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Section: Discussionmentioning

confidence: 88%

A case of acute tubulointerstitial nephritis following administration of the Oxford-AstraZeneca COVID-19 vaccine: a case report

et al. 2023

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“…ATIN is a relatively rare complication of COVID vaccines, with two cases reported until now to the best of our knowledge. The case reported by de la Flor Merino et al from Spain presented with pre-existing chronic kidney disease and developed ATIN following the Pfizer-BioNTech (BNT162b2) COVID-19 vaccine (7). The patient was diagnosed with ATIN based on blood and urine tests, pathological and radiological examinations.…”

Section: Discussionmentioning

confidence: 98%

Acute Tubulointerstitial Nephritis Following COVID-19 mRNA Vaccine: Case Report

Kantarcı¹,

Hacıhasanoğlu²,

Sekuri³

et al. 2022

J Nephropathol

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes Coronavirus disease-19 (COVID-19) continues to affect the world, as studies for vaccinations and treatments gather speed. One of the many types of COVID-19 vaccines is messenger RNA (mRNA) vaccine, which contains the selected sequence of the viral gene and can translate directly in the host cell’s cytoplasm to produce the target antigen. Several side effects of this type of vaccine have been reported in the literature, including renal complications. However, acute tubulointerstitial nephritis is a very rare complication of COVID-19 mRNA vaccine. Here we present a 50-year-old, previously healthy female who presented with renal failure following a COVID-19 mRNA BNT162b2 (Pfizer-BioNTech) vaccination and diagnosed as acute tubulointerstitial nephritis in the kidney biopsy. To the best of our knowledge, only two cases of acute tubulointerstitial nephritis following COVID-19 vaccine have been reported and one of them had an underlying kidney disease. This is the second case of acute tubulointerstitial nephritis following COVID-19 vaccine in a healthy individual.

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“…In addition, TIN was superimposed on glomerular pathologies in 25% of patients. Patients with isolated TIN after COVID-19 vaccination have been reported 20,[39][40][41][42] and may be another unmasking mechanism by exacerbating an unrecognized GN. According to WHO guidelines, adverse events (AE) following immunization can be defined as any untoward, unfavorable, or unintended medical occurrence after vaccination, not necessarily exhibiting a consistent, causal relationship with the vaccine product.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, TIN was superimposed on glomerular pathologies in 25% of patients. Patients with isolated TIN after COVID-19 vaccination have been reported 20,39-42 and may be another unmasking mechanism by exacerbating an unrecognized GN.…”

Section: Discussionmentioning

confidence: 99%

COVID-19 Vaccination and New Onset Glomerular Disease: Results from the IRocGN2 International Registry

Waldman¹,

Sinaii

Lerma

et al. 2023

Kidney360

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Background:Cases of de novo glomerular disease with various renal histologies have been reported after vaccination against SARS-CoV-2. Causality has not been established and the long-term outcomes are not known. To better characterize the glomerular diseases and clinical course/outcomes, we created the International Registry of COVID-19 vaccination and Glomerulonephritis (IRocGN2) to study in aggregate de novo glomerulonephritis cases suspected after COVID-19 vaccine exposure Methods:A RedCap survey was used for anonymized data collection. Detailed information on vaccination type and timing and glomerular disease histology were recorded in the registry. We collected serial information on laboratory values (before and after vaccination and during follow-up), treatments, and kidney-related outcomes. Results: Ninety-eight glomerular disease cases were entered into the registry over eleven months from 44 centers throughout the world. Median follow-up was 89 days after diagnosis. IgA nephropathy (IgAN) and minimal change disease (MCD) were the most the common kidney diseases reported. Recovery of kidney function and remission of proteinuria was more likely in IgAN and MCD at 4-6 months than with pauci immune glomerulonephritis /vasculitis and membranous nephropathy. Conclusions:Development of glomerular disease after vaccination against SARS-CoV-2 may be a very rare adverse event. Temporal association is present for IgAN and MCD, but causality is not firmly established. Kidney outcomes for IgAN and MCD are favorable. No changes in vaccination risk-benefit assessment is recommended based on these findings.

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A case of acute interstitial nephritis following the Pfizer–BioNTech COVID-19 vaccine

Cited by 7 publications

References 10 publications

A case of acute tubulointerstitial nephritis following administration of the Oxford-AstraZeneca COVID-19 vaccine: a case report

A case of acute tubulointerstitial nephritis following administration of the Oxford-AstraZeneca COVID-19 vaccine: a case report

Acute Tubulointerstitial Nephritis Following COVID-19 mRNA Vaccine: Case Report

COVID-19 Vaccination and New Onset Glomerular Disease: Results from the IRocGN2 International Registry

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