Secondary immunoglobulin A nephropathy with gross hematuria leading to rapidly progressive glomerulonephritis following severe acute respiratory syndrome coronavirus 2 vaccination: a case report

BMC Nephrology

Case Report

Akira Shimizu¹  Miyako Fukuda²  Tomohiro Kaneko²  Takahiro Kawai²  Hiromasa Ishii² 

[1] Department of Analytic Human Pathology, Nippon Medical School, Bunkyo-Ku, Tokyo, Japan;Department of Nephrology, Nippon Medical School Tama-Nagayama Hospital, Tama, Tokyo, Japan;

关键词: COVID-19;    SARS-CoV-2 vaccine;    IgA nephropathy;    Case report;    Gross hematuria;    Rapidly progressive glomerulonephritis;    Secondary IgA;    Cirrhosis;   

DOI  :  10.1186/s12882-023-03287-y

 received in 2022-02-05, accepted in 2023-08-02,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundThe outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been followed by many reports of the development and relapse of autoimmune diseases associated with SARS-CoV-2 vaccination. Some of these reports have involved relapse or onset of immunoglobulin A (IgA) nephropathy following SARS-CoV-2 vaccination. Here, we report on a patient with IgA nephropathy who presented with gross hematuria and rapidly progressive glomerulonephritis following SARS-CoV-2 vaccination.Case presentationA 63-year-old male patient with a history of habitual tonsillitis underwent bilateral tonsillectomy. He had a history of alcoholic cirrhosis of the liver and microscopic hematuria and proteinuria were indicated during a health checkup 2 years before hospital admission. He developed hematuria after the SARS-CoV-2 vaccination, which led to rapidly progressive glomerulonephritis, for which he was hospitalized. A renal biopsy led to the diagnosis of IgA nephropathy. Although pulse steroid therapy during his condition resulted in hepatic encephalopathy, three courses combined with mizoribine improved his renal function.ConclusionSARS-CoV-2 mRNA vaccines activate T cells, which are involved in the pathophysiology of IgA nephropathy. Therefore, this case suggests that the exacerbation of IgA nephropathy by the vaccine favors the vasculitis aspect of the disease.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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