Collapsing glomerulopathy following SARS-CoV-2 adenovirus-vector–based vaccine: report of 2 cases

Neves, Precil Diego Miranda de Menezes; Caires, Renato Antunes; Guimarães, Manoel Pereira; Costalonga, Elerson Carlos; Cavalcante, Lívia Barreira; Silva, Verônica T. Costa e; Mattedi, Francisco Z.; Santana, Leonardo Fernandes e; Teixeira-Júnior, Antonio; Gomes, Orlando Vieira; Silva, Gyl E.; Burdmann, Emmanuel A.; Onuchic, Luiz Fernando

doi:10.1016/j.kint.2021.12.016

Cited by 9 publications

(8 citation statements)

References 5 publications

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“…We also reported a case of collapsing glomerulopathy. The same finding has been reported both in few cases on native kidney [23,33] and on transplanted kidney [34].…”

Section: Discussionsupporting

confidence: 86%

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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“…We also reported a case of collapsing glomerulopathy. The same finding has been reported both in few cases on native kidney [23,33] and on transplanted kidney [34].…”

Section: Discussionsupporting

confidence: 86%

New Onset Biopsy-Proven Nephropathies after COVID Vaccination

et al. 2022

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“…It is well established that the immune response generated by the most diverse vaccines, such as vaccines against meningococcus C and B virus, influenza, and diphtheriatetanus-pertussis (DTP), is a potential trigger for developing or reactivating nephrotic syndrome (36)(37)(38)(39)(40). However, in the most recently published studies related to post-vaccination conditions against COVID-19, in addition to nephrotic conditions, other forms of renal involvement have been reported, such as acute tubular necrosis and thrombotic microangiopathies (Table 1).…”

Section: Morphological Findings In Renal Involvement Post Covid-19 Va...mentioning

confidence: 99%

“…More than 8.2 billion COVID-19 vaccine doses have been administered globally to contain the contamination and mortality curve of the new coronavirus, resulting in a substantial reduction in the number of cases and deaths in several countries ( 36 ). Although adverse renal effects are rare in the context of COVID-19 vaccination, some cases of adverse effects in various organs, including the kidneys, have been reported and have been of concern to nephrologists ( 37 ).…”

Section: Morphological Findings In Renal Involvement Post Covid-19 Va...mentioning

confidence: 99%

Kidney injury associated with COVID-19 infection and vaccine: A narrative review

et al. 2022

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The respiratory tract is the main infection site for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), resulting in many admissions to intensive care centers in several countries. However, in addition to lung involvement, kidney injury caused by the novel coronavirus has proven to be a significant factor related to high morbidity and mortality, alarming experts worldwide. The number of deaths has drastically reduced with the advent of large-scale immunization, highlighting the importance of vaccination as the best way to combat the pandemic. Despite the undeniable efficacy of the vaccine, the renal side effects associated with its use deserve to be highlighted, especially the emergence or reactivation of glomerulopathies mentioned in some case reports. This study aimed to identify the main renal morphological findings correlated with COVID-19 infection and its vaccination, seeking to understand the pathophysiological mechanisms, main clinical features, and outcomes.

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“…In these large populations, there have been reports of rare de novo immunological glomerular diseases following vaccination, including both mRNA-based and adenoviral vector-based vaccines [ 1 , 2 ]. The reported glomerular diseases after adenoviral vector-based vaccines include minimal change disease, collapsing glomerulopathy, IgA nephropathy, and acute tubulointerstitial nephritis [ 3 , 4 , 5 ]. There have been reports of de novo anti-glomerular basement membrane (anti-GBM) disease following mRNA COVID-19 vaccine [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Anti-GBM Disease after Oxford-AstraZeneca ChAdOx1 nCoV-19 Vaccination: A Report of Two Cases

Coorey

Phua

Chou

et al. 2022

Case Rep Nephrol Dial

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There have been reports of rare de novo glomerular diseases following vaccination for coronavirus disease 2019 (COVID-19). We report two cases of anti-glomerular basement membrane (GBM) disease in previously healthy females after Oxford-AstraZeneca COVID-19 vaccine (ChAdOx1 nCoV-19). The first case was a 69-year-old female who developed lethargy and anuria approximately 8 weeks after her first dose of Oxford-AstraZeneca COVID-19 vaccine. The second case was a 72-year-old female who developed malaise and diarrhoea approximately 3 weeks after her second dose of Oxford-AstraZeneca COVID-19 vaccine. Both cases had severe acute kidney injury, raised anti-GBM antibody titres, and renal biopsies consistent with anti-GBM disease. Both cases were commenced on haemodialysis and treated with high dose glucocorticoids, cyclophosphamide, and plasmapheresis. Neither patient had recovery of renal function, and both remain dialysis dependent. These cases add to the previously reported cases of anti-GBM disease after mRNA COVID-19 vaccination. As more COVID-19 vaccinations are administered worldwide, it would be important for clinicians to be aware of this possible association, and continued surveillance is warranted.

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Collapsing glomerulopathy following SARS-CoV-2 adenovirus-vector–based vaccine: report of 2 cases

Cited by 9 publications

References 5 publications

New Onset Biopsy-Proven Nephropathies after COVID Vaccination

New Onset Biopsy-Proven Nephropathies after COVID Vaccination

Kidney injury associated with COVID-19 infection and vaccine: A narrative review

Anti-GBM Disease after Oxford-AstraZeneca ChAdOx1 nCoV-19 Vaccination: A Report of Two Cases

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