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  1. Article ; Online: Membranous nephropathy in a patient with coronavirus disease 2019 (COVID-19): A case report.

    Miao, Jing / Fidler, Mary E / Nasr, Samih H / Larsen, Christopher P / Zoghby, Ziad M

    Clinical nephrology. Case studies

    2021  Volume 9, Page(s) 11–18

    Abstract: ... disease 2019 (COVID-19), kidney dysfunction, presenting with acute kidney injury (AKI), is also common ... chronic kidney disease (CKD) stage 3 who developed ATI in the setting of COVID-19. The patient was hospitalized ... a case of membranous nephropathy (MN) in an 81-year-old Hispanic man with underlying ...

    Abstract Introduction: Though respiratory, immune, and coagulation systems are major targets of coronavirus disease 2019 (COVID-19), kidney dysfunction, presenting with acute kidney injury (AKI), is also common. Most AKI cases in COVID-19 manifest as acute tubular injury (ATI) in conjunction with multiorgan failure. While initial renal pathological findings were limited to acute tubular necrosis and collapsing glomerulopathy, a recent case series reported a larger spectrum of findings.
    Case report: Here, we report a case of membranous nephropathy (MN) in an 81-year-old Hispanic man with underlying chronic kidney disease (CKD) stage 3 who developed ATI in the setting of COVID-19. The patient was hospitalized for hypoxic respiratory failure in the setting of AKI stage 3 with serum creatinine 7.1 mg/dL 6 days after a positive-SARS-CoV-2 screening. He was found to have nephrotic range proteinuria, glycosuria (with normal serum glucose), anemia, and hypoalbuminemia. Kidney biopsy showed ATI and early MN. Workup for primary and secondary MN was unrevealing, and serum PLA2R antibody was negative. No viral particles were observed in podocytes.
    Conclusion: Although the MN could be incidental, this observation raises the question of whether SARS-CoV-2 infection can trigger or worsen an underlying MN from an exaggerated immune response associated with COVID-19.
    Language English
    Publishing date 2021-02-19
    Publishing country Germany
    Document type Case Reports
    ISSN 2196-5293
    ISSN (online) 2196-5293
    DOI 10.5414/CNCS110379
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: IgG4-Related Membranous Nephropathy After COVID-19 Vaccination: A Case Report.

    Mizuno, Tomohito / Endo, Yoko / Suzuki, Atsushi / Suzuki, Masashi

    Cureus

    2024  Volume 16, Issue 3, Page(s) e56028

    Abstract: ... following coronavirus disease 2019 (COVID-19) mRNA vaccination have been reported. However, there are no ... of IgG4-related membranous nephropathy (MN) occurring after COVID-19 vaccination. A 69-year-old Japanese ... reports of IgG4-related glomerulonephritis following COVID-19 vaccination. Herein, we present a case ...

    Abstract Although immunoglobulin G4 (IgG4)-related kidney diseases are typically characterized by tubulointerstitial nephritis with abundant infiltration of IgG4-positive plasma cells and fibrosis, there have been relatively rare cases of IgG4-related glomerulonephritis. Several cases of IgG4-related disease (IgG4-RD) following coronavirus disease 2019 (COVID-19) mRNA vaccination have been reported. However, there are no reports of IgG4-related glomerulonephritis following COVID-19 vaccination. Herein, we present a case of IgG4-related membranous nephropathy (MN) occurring after COVID-19 vaccination. A 69-year-old Japanese male presented to our hospital with edema that started the day after his second COVID-19 vaccination. The patient exhibited nephrotic syndrome and was diagnosed with MN based on the results of a kidney biopsy. Although serum IgG4 levels were elevated to 946 mg/dL, no evidence of organ involvement suggestive of IgG4-RD was observed. Treatment with prednisolone and cyclosporine resulted in complete remission, and immunosuppressive agents were tapered. However, one month after discontinuing the immunosuppressive agents, the patient was readmitted with swelling around the submandibular glands and exertional dyspnea. Serum IgG4 level was markedly elevated at 2,320 mg/dL, and computed tomography revealed submandibular gland swelling and thickening of the interlobular septum and bronchovascular bundles in both lungs. The patient was diagnosed with IgG4-RD based on elevated serum IgG4 levels and infiltration of IgG4-positive plasma cells in the submandibular gland biopsy. Upon resuming treatment with prednisolone, the symptoms attributed to IgG4-RD improved within a few days. In cases of nephrotic syndrome following COVID-19 vaccination, it may be advisable to conduct detailed examinations to assess the possibility of the development of IgG4-RDs.
    Language English
    Publishing date 2024-03-12
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.56028
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article: A Case of Membranous Nephropathy Hypothesized to be Associated With COVID-19 Vaccine.

    Rashid, Wahida / Mousa, Heba / Khan, Jahanzeb / Ijaz, Fakhar / Ezell, Gerry D

    Cureus

    2022  Volume 14, Issue 4, Page(s) e24245

    Abstract: ... at his primary care physician's office. The patient reported that he had developed a coronavirus disease 2019 (COVID-19)-like ... cases reported with new onset of glomerular disease after receiving the COVID-19 vaccine. Further studies ... interstitial nephritis. Positive staining for PLA2R in the glomerular deposits suggested primary membranous nephropathy ...

    Abstract A 56-year-old male patient with a medical history of essential hypertension was referred to the emergency room after he was found to have a serum creatinine level of 13 mg/dL at his primary care physician's office. The patient reported that he had developed a coronavirus disease 2019 (COVID-19)-like infection six months prior that was not confirmed. Two months later, he started to notice dyspnea on exertion and bilateral lower limb swelling and was started on furosemide. He received the first dose of the Moderna COVID-19 vaccine a month before the presentation but did not receive the second dose. Subsequently, his lower limb swelling and exertional dyspnea started worsening. He denied any new medication, dysuria, oliguria, hematuria, fever, or any other symptoms. Initial evaluation was consistent with kidney failure. Hypocalcemia and hyperphosphatemia were noted, along with medical renal disease on renal ultrasound. Eosinophils and nephrotic-range proteinuria were found in the urine. His serum phospholipase A2 receptor (PLA2R) antibodies were positive. A renal biopsy showed membranous glomerulonephritis with moderate segmental sclerosis, as well as tubulointerstitial fibrosis with neutrophils, consistent with acute interstitial nephritis. Positive staining for PLA2R in the glomerular deposits suggested primary membranous nephropathy (MN). He was treated with prednisone first, and when the kidney biopsy was conclusive for membranous glomerulopathy, he was started on rituximab. On admission, he received hemodialysis intermittently, but this was stopped a month after discharge as his renal function normalized. Recently, there have been numerous cases reported with new onset of glomerular disease after receiving the COVID-19 vaccine. Further studies of vaccinated patients are needed to determine whether the severe acute respiratory syndrome coronavirus 2 virus vaccination is associated with a higher risk of MN and to identify potential predisposing factors and mechanisms of kidney injury in patients in whom it occurs.
    Language English
    Publishing date 2022-04-18
    Publishing country United States
    Document type Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.24245
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Rapidly progressive IgA nephropathy with membranoproliferative glomerulonephritis-like lesions in an elderly man following the third dose of an mRNA COVID-19 vaccine: a case report.

    Morimoto, Nobuhisa / Mori, Takayasu / Shioji, Shingo / Taguchi, Towako / Watanabe, Hatsumi / Sakai, Keigo / Mori, Katsuo / Yamamura, Ayumi / Hanioka, Asami / Akagi, Yuichiro / Fujiki, Tamami / Mandai, Shintaro / Mori, Yutaro / Ando, Fumiaki / Susa, Koichiro / Iimori, Soichiro / Naito, Shotaro / Sohara, Eisei / Ohashi, Kenichi /
    Uchida, Shinichi

    BMC nephrology

    2023  Volume 24, Issue 1, Page(s) 108

    Abstract: Background: As messenger RNA (mRNA)-based vaccines for coronavirus disease 2019 (COVID-19) have ... vaccine (mRNA-1273) for COVID-19. On admission, the patient presented severe renal failure with a serum ... We report a case of rapidly progressive glomerulonephritis in a patient following the third dose of an mRNA ...

    Abstract Background: As messenger RNA (mRNA)-based vaccines for coronavirus disease 2019 (COVID-19) have been administered to millions of individuals worldwide, cases of de novo and relapsing glomerulonephritis after mRNA COVID-19 vaccination are increasing in the literature. While most previous publications reported glomerulonephritis after the first or second dose of an mRNA vaccine, few reports of glomerulonephritis occurring after the third dose of an mRNA vaccine currently exist.
    Case presentation: We report a case of rapidly progressive glomerulonephritis in a patient following the third dose of an mRNA COVID-19 vaccine. A 77-year-old Japanese man with a history of hypertension and atrial fibrillation was referred to our hospital for evaluation of anorexia, pruritus, and lower extremity edema. One year before referral, he received two mRNA vaccines (BNT162b2) for COVID-19. Three months before the visit, he received a third mRNA vaccine (mRNA-1273) for COVID-19. On admission, the patient presented severe renal failure with a serum creatinine level of 16.29 mg/dL, which had increased from 1.67 mg/dL one month earlier, prompting us to initiate hemodialysis. Urinalysis showed nephrotic-range proteinuria and hematuria. Renal biopsy revealed mild mesangial proliferation and expansion, a lobular appearance, and double contours of the glomerular basement membrane. Renal tubules had severe atrophy. Immunofluorescence microscopy showed strong mesangial staining for IgA, IgM, and C3c. Electron microscopy exhibited mesangial and subendothelial electron-dense deposits, leading to a diagnosis of IgA nephropathy with membranoproliferative glomerulonephritis-like changes. The kidney function remained unchanged after steroid therapy.
    Conclusions: Although the link between renal lesions and mRNA vaccines remains unclear, a robust immune response induced by mRNA vaccines may play a role in the pathogenesis of glomerulonephritis. Further studies of the immunological effects of mRNA vaccines on the kidney are warranted.
    MeSH term(s) Male ; Humans ; Aged ; Glomerulonephritis, IGA/diagnosis ; Glomerulonephritis, Membranoproliferative/pathology ; COVID-19 Vaccines ; BNT162 Vaccine ; COVID-19/complications ; Glomerulonephritis/pathology
    Chemical Substances COVID-19 Vaccines ; BNT162 Vaccine
    Language English
    Publishing date 2023-04-24
    Publishing country England
    Document type Case Reports ; Journal Article
    ZDB-ID 2041348-8
    ISSN 1471-2369 ; 1471-2369
    ISSN (online) 1471-2369
    ISSN 1471-2369
    DOI 10.1186/s12882-023-03169-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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