A Case of Acute Interstitial Nephritis After Two Doses of the BNT162b2 SARS-CoV-2 Vaccine

Abstract

Background The development of vaccines to prevent COVID-19 breakouts came with highly positive results but some unexpected side effects. Rare side effects have been seen with the BNT162b2 SARS-CoV 2 vaccine. Case Presentation We present the case of a 45-year-old female patient who developed an acute kidney injury needing urgent hemodialysis one week after the second administration of the BNT162b2 SARS-CoV 2 vaccine. She developed a macular rash on her lower limbs and palms as well. A kidney biopsy was performed 10 days after vaccine inoculation, diagnosing acute interstitial nephritis and acute tubular necrosis with cellular casts. The patient was treated with three corticosteroid pulses followed by daily prednisolone. We witnessed clinical improvement 4 days after the initial corticosteroid treatment with progressive recovery of kidney function and hemodialysis withdrawal. After 2 weeks, the patient had recovered her kidney function. Immunophenotyping was performed, diagnosing a hypersensitivity to the vaccine and the polyethylene glycol excipient. Conclusion Patients may develop acute reactions to vaccines. In this case, symptoms seem to correlate significantly with its inoculation and, although this case had a favourable outcome, these side effects must be made aware for clinicians and patients.

New-Onset Kidney Diseases after COVID-19 Vaccination: A Case Series

“…Acute tubulointerstitial nephritis (ATIN) can be caused by a hypersensitivity reaction from the use of various vaccines or drugs [18][19][20]. The development of ATIN is suggested to be caused by a T lymphocyte-mediated injury with an aberrant innate and consequent acquired immune response [21][22][23].…”

“…Ingredients found in COVID-19 vaccines, such as mRNA and polyethylene glycol, are known to be immunogenic agents and can induce a hypersensitivity-like reaction [22,24]. Some ATIN cases after COVID-19 vaccination have been observed and responded well to steroid treatment [4,18]. The occurrence of muscle syndromes, such as myalgia, myositis, and rhabdomyolysis, is a well-known side effect of vaccination [25].…”

New-Onset Acute Kidney Disease Post COVID-19 Vaccination

“…As of 28 February 2022, we found a total of 38 published articles (53 cases) on AKI after SARS-CoV-2 vaccination ( Table 1 ) [ 11 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 ]. Only one case clearly identified an increase in Scr and a resolve within 7 days after vaccination [ 30 ].…”

Reações adversas pós-vacinação por COVID-19: uma revisão integrativa

“…Relatos de casos incluídos mostram diversas reações adversas graves, sendo elas; renais, como síndrome nefrótica e lesão renal (Abdulgayoom et al 2021;Mira et al 2021); reações dermatológicas, como a síndrome de Sweet (Baffa et al…”

“…2021) e o exantema intertriginoso e flexural(SDRIFE) (Hai et al, 2021), reações oftalmológicas como retinopatia serosa e oclusão de veia retiniana de ramo(ORVR) (Fowler et al 2021) Em relação ao sexo a maior incidência de reações adversas ocorrem em pessoas do sexo feminino (Alghamdi et al 2021;Almohaya et al 2021;Javed et al 2021;Kitagawa et al 2021;Klugar et al 2021;Mcmahon et al 2021;Omeish et al 2021;Riad et al 2021;Saita et al 2021;Vigezzi et al 2021). Entre as reações adversas graves que constam na pesquisa, quatro delas são pacientes do sexo feminino (Ahmad et al 2021;Cieslewicz et al 2021;Hai et al 2021;Kim et al 2021;Mira et al 2021), e uma reação adversa fatal (Ameratunga et al 2021).…”