ANCA-Associated Vasculitis after Moderna COVID-19 Vaccination

Gen, Shiko; Iwai, Takanori; Ohnari, Sayuri; Nobe, Kanako; Ikeda, Naofumi

doi:10.1155/2023/4906876

Cited by 5 publications

(3 citation statements)

References 21 publications

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“…The three most common small vessel vasculitis were ANCA-associated vasculitis (AAV) (33/64, 51%), cutaneous vasculitis (22/64, 34%), and Henoch-Schoenlein purpura (HSP) (5/64, 7%). Out of AAV patients, the majority (20) had positive Myeloperoxidase Antibody (MPO) ANCA with titres ranging from 1.1 units/mL to 3500 units/mL [41][42][43][44][45][46]48,96,116,122,124,128,137,150,160,168,178,182,183,187], and nine were proteinase-3 (PR3) ANCA positive, ranging from 6.7 units to 259 units. Of AAV, 24/30 patients developed biopsy-proven crescentic glomerulonephritis [38,41,42,45,46,48,51,52,55,96,116,122,124,128,130,136,137,150,157,160,168,178,182,187].…”

Section: Small-vessel Vasculitismentioning

confidence: 99%

“…Out of AAV patients, the majority (20) had positive Myeloperoxidase Antibody (MPO) ANCA with titres ranging from 1.1 units/mL to 3500 units/mL [41][42][43][44][45][46]48,96,116,122,124,128,137,150,160,168,178,182,183,187], and nine were proteinase-3 (PR3) ANCA positive, ranging from 6.7 units to 259 units. Of AAV, 24/30 patients developed biopsy-proven crescentic glomerulonephritis [38,41,42,45,46,48,51,52,55,96,116,122,124,128,130,136,137,150,157,160,168,178,182,187]. Six had pulmonary and renal syndrome [45,55,137,...…”

Section: Small-vessel Vasculitismentioning

confidence: 99%

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New-Onset Rheumatic Immune-Mediated Inflammatory Diseases Following SARS-CoV-2 Vaccinations until May 2023: A Systematic Review

Nune,

Durkowski,

Pillay

et al. 2023

Vaccines

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A comprehensive, up-to-date systematic review (SR) of the new-onset rheumatic immune-mediated inflammatory diseases (R-IMIDs) following COVID-19 vaccinations is lacking. Therefore, we investigated the demographics, management, and prognosis of new R-IMIDs in adults following SARS-CoV-2 vaccinations. A systematic literature search of Medline, Embase, Google Scholar, LitCovid, and Cochrane was conducted. We included any English-language study that reported new-onset R-IMID in adults following the post-COVID-19 vaccination. A total of 271 cases were reported from 39 countries between January 2021 and May 2023. The mean age of patients was 56 (range 18–90), and most were females (170, 62.5%). Most (153, 56.5%) received the Pfizer BioNTech COVID-19 vaccine. Nearly 50% of patients developed R-IMID after the second dose of the vaccine. Vasculitis was the most prevalent clinical presentation (86, 31.7%), followed by connective tissue disease (66, 24.3%). The mean duration between the vaccine’s ‘trigger’ dose and R-IMID was 11 days. Most (220, 81.2%) received corticosteroids; however, 42% (115) received DMARDs such as methotrexate, cyclophosphamide, tocilizumab, anakinra, IV immunoglobulins, plasma exchange, or rituximab. Complete remission was achieved in 75 patients (27.7%), and 137 (50.6%) improved following the treatment. Two patients died due to myositis. This SR highlights that SARS-CoV-2 vaccines may trigger R-IMID; however, further epidemiology studies are required.

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Section: Small-vessel Vasculitismentioning

confidence: 99%

Section: Small-vessel Vasculitismentioning

confidence: 99%

New-Onset Rheumatic Immune-Mediated Inflammatory Diseases Following SARS-CoV-2 Vaccinations until May 2023: A Systematic Review

Nune,

Durkowski,

Pillay

et al. 2023

Vaccines

View full text Add to dashboard Cite

show abstract

“…Of the 4,102 articles, 48 were assessed for eligibility, and 29 articles, including case reports and case series, were included in the review, reporting 35 patients with COVID-19 vaccine-induced p-ANCA GN. Each study’s characteristics (author and publication year), patient demographics (age and sex), previous medical history, COVID-19 vaccine type, vaccine dose, time to onset of p-ANCA-associated GN post-vaccination, clinical presentation, laboratory findings, histopathological features, treatment modalities, and clinical outcomes are tabulated in Table 3 [ 8 , 10 - 12 , 15 - 39 ].…”

Section: Reviewmentioning

confidence: 99%

A Systematic Review of Perinuclear Antineutrophil Cytoplasmic Antibody-Associated Glomerulonephritis Following Coronavirus Disease 2019 Vaccination: A 2024 Update

Ogieuhi,

Suman,

Kumari

et al. 2024

Cureus

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Antineutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis (GN) is an immune-mediated kidney disease characterized by the inflammation of small blood vessels in the kidney, leading to renal impairment and potentially irreversible damage. Concerns have been raised over the reports of myeloperoxidase/perinuclear (MPO/p) ANCA GN following the coronavirus disease 2019 (COVID-19) vaccination. Our study provides a comprehensive insight into perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA) GN after COVID-19 vaccination. We conducted a comprehensive literature search on PubMed, Cochrane Library, and EMBASE using the Medical Subject Headings (MeSH) terms related to “covid-19 vaccine,” “glomerulonephritis,” “p-ANCA,” and “MPO-ANCA” up to March 5, 2024, to include cases of p-ANCA-associated GN following COVID-19 vaccination. Of the 4,102 articles, we included 29, reporting 35 patients demonstrating COVID-19 vaccine-induced p-ANCA GN, with 23 (65.7%) females and a median age of 69 years (mean ± SD = 63.22 ± 16). Twenty-six (74.28%) patients received the mRNA vaccine (Pfizer = 19, Moderna = 7). Seventeen (48.57%) patients presented with p-ANCA GN after the second dose of the COVID-19 vaccine, with a median gap of 19 days (1-84 days). Constitutional symptoms (54.28%) and acute kidney injury (42.85%) were the most reported initial presentations, and elevated serum creatinine (mean peak serum creatinine = 4.98 ± 5.02 mg/dL), hematuria, and proteinuria were the laboratory findings. MPO/p-ANCA was positive in 31 (88.6%) patients. All patients underwent renal biopsy, and crescentic GN was the most common finding among 27 (77.14%) patients. Management of p-ANCA GN included steroids in 30 (85.71%) patients, followed by rituximab (28.57%), and plasmapheresis (22.86%). Most patients responded well to treatment, with complete remission in 29 (82.86%) and relapse in four (11.42%) patients. Two patients did not achieve remission and became dialysis dependent. ANCA-associated GN is a rare and life-threatening complication of the COVID-19 vaccine, necessitating urgent evaluation and management. COVID-19 vaccine-induced p-ANCA GN should be included in the differential diagnoses of patients presenting with kidney injury after vaccination.

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Elasomeran

2023

Reactions Weekly

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ANCA-Associated Vasculitis after Moderna COVID-19 Vaccination

Cited by 5 publications

References 21 publications

New-Onset Rheumatic Immune-Mediated Inflammatory Diseases Following SARS-CoV-2 Vaccinations until May 2023: A Systematic Review

New-Onset Rheumatic Immune-Mediated Inflammatory Diseases Following SARS-CoV-2 Vaccinations until May 2023: A Systematic Review

A Systematic Review of Perinuclear Antineutrophil Cytoplasmic Antibody-Associated Glomerulonephritis Following Coronavirus Disease 2019 Vaccination: A 2024 Update

Elasomeran

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