Minimal change disease following the Moderna COVID-19 vaccine: first case report

Area of Science:

• Nephrology
• Immunology
• Vaccinology

Background:

• Minimal change disease (MCD) is a known, albeit rare, complication associated with certain vaccines.
• Previous reports have documented MCD following the Pfizer-BioNTech COVID-19 vaccine, including new-onset cases and relapses.
• This study introduces the first reported case of MCD occurring after administration of the Moderna COVID-19 vaccine.

Observation:

• A 43-year-old male presented with bilateral lower extremity and scrotal edema three weeks post-Moderna COVID-19 vaccination.
• Clinical presentation included hypertension, pulmonary findings, hypoalbuminemia, hyperlipidemia, and significant proteinuria.
• Renal biopsy revealed minimal change disease (MCD) coexisting with IgA nephropathy.

Findings:

• The patient experienced a favorable response to oral steroid therapy, with resolution of edema, improved serum albumin, and decreased proteinuria within two weeks.
• The case represents the first documented instance of new-onset MCD following the Moderna COVID-19 vaccine.
• Laboratory and serological workups were negative, suggesting a direct link to the vaccine or an idiopathic event.

Implications:

• The findings suggest a potential association between the Moderna COVID-19 mRNA vaccine and the development of minimal change disease (MCD).
• Further research is crucial to establish causality, determine the incidence of MCD post-COVID-19 vaccination, and elucidate the mechanisms of vaccine-induced glomerular injury.
• This case underscores the importance of monitoring for rare adverse events following widespread vaccination campaigns.