Relapse of primary membranous nephropathy after inactivated SARS-CoV-2 virus vaccination

Aydın, Mehmet; Yıldız, Abdülmecit; Oruç, Ayşegül; Sezen, Mehmet; Dilek, Kamıl; Güllülü, Mustafa; Yavuz, Mahmut; Ersoy, Alparslan

doi:10.1016/j.kint.2021.05.001

Cited by 63 publications

(53 citation statements)

References 4 publications

(1 reference statement)

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“…Our observation, together with other case reports of MN development post COVID-19 infection 2,3 and MN relapse post COVID-19 vaccine 1 , supports a possible immune dysregulation process causing loss of tolerance to certain podocyte antigens, which requires further studies to elucidate.…”

supporting

confidence: 78%

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

Goh

Khatri

2021

Kidney International

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supporting

confidence: 78%

“…To the Editor: We read recent report describing the relapse of membranous nephropathy (MN) following inactivated vaccine against Coronavirus 2019 (COVID-19) 1 . Here, we describe a case of new onset MN following Pfizer-BioNTech mRNA based COVID-19 vaccine.…”

mentioning

confidence: 99%

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

Goh

Khatri

2021

Kidney International

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“…A recent case series [2] reported a wide spectrum of glomerular and tubular diseases, including two cases of membranous nephropathy, one of which was PLA2R positive. Two other cases of PLA2R positive membranous nephropathy after COVID-19 infection were mentioned in a case report [3]. However, most cases of membranous nephropathy associated with COVID-19 infection that have been reported were PLA2R negative [1,2].…”

Section: Lessons For the Clinical Nephrologistmentioning

confidence: 91%

“…The target antigen in membranous glomerulopathy, PLA2R, is also expressed in the respiratory tract [5], potentially triggering anti-PLA2R immune response. Relapse in primary membranous nephropathy associated with inactivated vaccine against COVID-19 has also been reported [3].…”

Section: Lessons For the Clinical Nephrologistmentioning

confidence: 94%

Membranous nephropathy in a patient with COVID-19 infection

2021

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Case descriptionA 29-year-old South Asian male presented with fever, myalgia and lower limb swelling of 3 days duration. Four weeks prior to presentation, he had been diagnosed with COVID-19 infection and was treated symptomatically in the community isolation facility.He was diagnosed to have nephrotic syndrome with proteinuria of 8.71 g/24 h and serum albumin of 22 g/L. He also had acute kidney injury with peak serum creatinine of 145 µmol/L, estimated glomerular filtration rate (eGFR) of 65 mL/min per 1.73 m 2 . Urinalysis revealed few dysmorphic red blood cells and presence of white blood cells. Antinuclear antibody, anti-double stranded DNA, antineutrophil cytoplasmic antibodies were negative. Hepatitis B, Hepatitis C and HIV screens were negative and ultrasound imaging showed normal kidneys.Kidney biopsy showed 28 glomeruli with diffusely thickened capillary walls. Some glomeruli displayed segmental increases in mesangial cells amid expanded mesangial matrix. Masson-silver stains showed tiny fuchsinophilic subepithelial deposits and fine vacuolization of tangentially sectioned portions of the glomerular basement membranes (Fig. 1). Immunofluorescence showed 3 + finely granular staining for IgG along glomerular capillary walls, with focal weak segmental staining for anti-phospholipase A2 receptor (PLA2R) regarded as of uncertain significance (Fig. 2).Electron microscopy revealed thickened glomerular basement membranes and subepithelial electron dense deposits.

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“…To the editors, SARS-Cov-2 vaccination is currently recommended for patients with chronic kidney disease and immunocompromised patients because their risk of developing severe forms of Covid-19 is higher than other patients. Several reports have highlighted the increased risk of immune disease recurrence following mRNA vaccination, including Minimal Change Disease, Membranous Nephropathy or even acute allograft rejection 1,2 . We report the case of a 66-year-old man who was diagnosed with IgG4 Related Disease (IgG4-RD) nephritis in December 2019.…”

mentioning

confidence: 99%