Development of IgA vasculitis with severe glomerulonephritis after COVID-19 vaccination: a case report and literature review.
CEN Case Rep
; 11(4): 436-441, 2022 11.
Article
em En
| MEDLINE
| ID: mdl-35275366
ABSTRACT
With the worldwide spread of the COVID-19 vaccine program during the COVID-19 pandemic, the numbers of reported cases with new-onset or relapsed kidney disease/vasculitis such as minimal change nephrotic syndrome, immunoglobulinA (IgA) nephropathy, and IgA vasculitis (IgAV) that developed after COVID-19 vaccination are increasing. We present the case of a 67-year-old Japanese woman who developed IgAV with purpura on her extremities and trunk in the evening of the day that she received the second dose of the Pfizer-BioNTech COVID-19 vaccine. She subsequently presented with acute kidney injury and nephrotic syndrome, and a kidney biopsy performed 14 days after the second vaccination showed diffuse mesangial and endocapillary glomerulonephritis with necrotizing crescent formation, accompanied by IgA deposition. One steroid pulse plus four administrations of a monthly intravenous cyclophosphamide injection were applied, followed by oral azathioprine during oral steroid tapering. Her response to this treatment was unsatisfactory and intractable for some time. Eventually, her renal function improved and nephrotic syndrome was resolved, while microscopic hematuria and proteinuria at ~ 1 g/gCr remained at 6 months post-vaccination. Unlike the previous milder renal-involved IgAV cases following COVID-19 vaccination, our patient's case presented severe glomerulonephritis and took a long time to recover despite intensive initial immunosuppressive treatment.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Contexto em Saúde:
1_ASSA2030
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2_ODS3
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4_TD
Problema de saúde:
1_doencas_nao_transmissiveis
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2_enfermedades_transmissibles
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2_muertes_prematuras_enfermedades_notrasmisibles
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4_pneumonia
Assunto principal:
Vasculite por IgA
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COVID-19
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Vacina BNT162
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Glomerulonefrite por IGA
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Síndrome Nefrótica
Limite:
Aged
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Female
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Humans
Idioma:
En
Revista:
CEN Case Rep
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Japão