A case of membranous nephropathy following Pfizer–BioNTech mRNA vaccination against COVID-19

Da, Yi; Goh, Giap Hean; Khatri, Priyanka

doi:10.1016/j.kint.2021.07.016

Cited by 35 publications

(22 citation statements)

References 3 publications

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“…This prevalence is confirmed in our cohort. Other authors have published reports on new-onset IgAN [ 23 , 24 , 25 , 26 ], MN [ 23 , 27 , 28 ], FSGS [ 23 ], and systemic vasculitis [ 29 ]. All these glomerular diseases were represented in our cohort.…”

Section: Discussionmentioning

confidence: 99%

New Onset Biopsy-Proven Nephropathies after COVID Vaccination

et al. 2022

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Introduction: To date, almost 7 billion doses of the different types of vaccine against SARS-CoV-2 have been administered worldwide. Although the severity of new cases of SARS-CoV-2 has progressively decreased, and the pressure on national health systems has declined, the development of de novo glomerular injuries has been suggested. Methods: This study aimed to examine the patients who were hospitalized in our Unit between April and November 2021 and underwent renal biopsy for new-onset urinary abnormalities (UA) and/or renal impairment within 3 months of SARS-CoV-2 vaccination. Results: We identified 17 patients who developed UA and/or renal insufficiency within 3 months of vaccination. Minimal change disease was the most common disease in our cohort (5 patients, 29.4%) followed by acute tubulointerstitial nephritis (TIN; 3 patients, 17.6%), membranous nephropathy (3 patients, 17.6%), and rapidly progressive IgA nephropathy (2 patients, 11.8%). The other 4 patients had a diagnosis of membranoproliferative glomerulonephritis (1 patient), systemic lupus erythematosus (1 patient), ANCA-associated vasculitis (1 patient), and tip-variant focal segmental glomerulosclerosis (1 patient), respectively. Eight out of the 17 patients (47.1%) developed acute kidney injury. Two patients with acute TIN had to start hemodialysis that was discontinued after 1 and 2 months, respectively, due to the recovery of renal function. All patients underwent treatment with corticosteroids and/or immunosuppressants. Discussion: Although it is not possible to conclusively determine whether there is a causal relationship between SARS-CoV-2 vaccination and new-onset nephropathies, based on the appearance of UA and/or renal insufficiency shortly after vaccination, we hypothesize that the immune response to the COVID-19 vaccine may be a trigger of nephropathies. Therefore, our results highlight the need for pharmacovigilance. However, this report should not lead to vaccine hesitation during this pandemic as the benefits of vaccination strongly outweigh the potential risks.

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Section: Discussionmentioning

confidence: 99%

New Onset Biopsy-Proven Nephropathies after COVID Vaccination

et al. 2022

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“…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 ].…”

Section: Clinical Characteristics Of Patientsmentioning

confidence: 99%

“…All patients had symptoms of edema. One new-onset patient received conservative treatment with no remission within 60 days [ 26 ]. The other new case developed MN and AKD after the first mRNA (Pfizer-BioNTech) vaccination, achieved partial remission after administration of renin-angiotensin system blockade (RASB), and Scr did not return to baseline levels.…”

Section: Clinical Characteristics and Follow-up Of Patients By Diseasementioning

confidence: 99%

New-Onset Acute Kidney Disease Post COVID-19 Vaccination

Rao

2022

Vaccines

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The coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused an exceptional setback to the global economy and health. Vaccination is one of the most effective interventions to markedly decrease severe illness and death from COVID-19. In recent years, there have been increasingly more reports of new acute kidney injury (AKI) after COVID-19 vaccination. Podocyte injury, IgA nephropathy, vasculitis, tubulointerstitial injury, and thrombotic microangiopathy appear to be the main pathological phenotypes. Nonetheless, whether the link between the COVID-19 vaccine and acute kidney disease (AKD) is causal or coincidental remains to be verified. Here, we generalize some hypotheses for the emergence of AKD and its pathogenesis in response to certain COVID-19 vaccines. In fact, the enormous benefits of mass vaccination against COVID-19 in preventing COVID-19 morbidity and mortality cannot be denied. The purpose of this review is to assist in the clinical assessment and management of AKD following COVID-19 vaccination.

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“…Elution of immune complexes from kidneys of patients with schistosomiasis identified reactivity against Schistosoma mansoni by indirect immunofluorescence (139). Recently in the COVID-19 pandemic, cases of MN have been reported in patients with SARS-CoV-2 infection, or post-SARS-CoV2 vaccination (140)(141)(142)(143)(144)(145)(146). There is an increased frequency of PLA2R-negative MN than expected for primary MN, however it is unclear whether this is due to molecular mimicry with a viral component, such as the spike protein.…”

Section: Infectious Triggers Of Membranous Nephropathymentioning

confidence: 99%

How Times Have Changed! A Cornucopia of Antigens for Membranous Nephropathy

2021

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The identification of the major target antigen phospholipase A2 receptor (PLA2R) in the majority of primary (idiopathic) cases of membranous nephropathy (MN) has been followed by the rapid identification of numerous minor antigens that appear to define phenotypically distinct forms of disease. This article serves to review all the known antigens that have been shown to localize to subepithelial deposits in MN, as well as the distinctive characteristics associated with each subtype of MN. We will also shed light on the novel proteomic approaches that have allowed identification of the most recent antigens. The paradigm of an antigen normally expressed on the podocyte cell surface leading to in-situ immune complex formation, complement activation, and subsequent podocyte injury will be discussed and challenged in light of the current repertoire of multiple MN antigens. Since disease phenotypes associated with each individual target antigens can often blur the distinction between primary and secondary disease, we encourage the use of antigen-based classification of membranous nephropathy.

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A case of membranous nephropathy following Pfizer–BioNTech mRNA vaccination against COVID-19

Cited by 35 publications

References 3 publications

New Onset Biopsy-Proven Nephropathies after COVID Vaccination

New Onset Biopsy-Proven Nephropathies after COVID Vaccination

New-Onset Acute Kidney Disease Post COVID-19 Vaccination

How Times Have Changed! A Cornucopia of Antigens for Membranous Nephropathy

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