Related Experiment Video
Updated: Jul 12, 2025
Intracranial Injection of Adeno-associated Viral Vectors
Published on: November 17, 2010
De Novo ANCA-Negative Pauci-Immune Crescentic Glomerulonephritis After COVID-19 mRNA Vaccination: A Case Report
Heejin Cho1, Hyun Soon Lee2, Su Hyun Kim3,4
1Division of Nephrology, Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea.
Insights
A case report details new-onset glomerulonephritis (GN) following the COVID-19 mRNA vaccine. This finding expands the known spectrum of vaccine-associated GN, highlighting potential kidney complications post-vaccination.
Area of Science:
- Nephrology
- Immunology
- Vaccinology
Background:
- The COVID-19 pandemic necessitated rapid vaccine development and deployment.
- Vaccine-associated adverse events are closely monitored for safety.
- Glomerulonephritis (GN) is a potential, though rare, complication of various medical interventions.
Observation:
- A 48-year-old man developed worsening renal insufficiency 1.5 months post-BNT162b2 vaccination.
- Symptoms included arthralgia, skin rash, abdominal pain, and diarrhea, with colonic findings suggestive of vasculitis.
- Kidney biopsy revealed anti-neutrophil cytoplasmic autoantibody (ANCA)-negative pauci-immune crescentic GN (CrGN) with nephrotic-range proteinuria.
Findings:
- The patient was diagnosed with de novo ANCA-negative pauci-immune crescentic GN after COVID-19 mRNA vaccination.
- Treatment with high-dose steroids and cyclophosphamide led to improved proteinuria and renal function.
- This represents the first reported case of this specific type of GN with extrarenal involvement post-vaccination.
Implications:
- This case expands the spectrum of potential renal adverse events associated with COVID-19 mRNA vaccines.
- It underscores the importance of considering vaccine-related etiologies in patients presenting with new-onset GN.
- Further research is warranted to understand the mechanisms and incidence of vaccine-associated GN.
Abstract:
To prevent the spread of the coronavirus disease 2019 (COVID-19) pandemic, vaccines have been authorized for emergency use and implemented worldwide. We present a case of de novo glomerulonephritis (GN) after use of the COVID-19 mRNA vaccine BNT162b2. A 48-year-old man with no relevant medical history was referred for sudden and persistent worsening of renal insufficiency 1.5 months after the second vaccine dose. He had arthralgia and skin rash a week after vaccination. Abdominal pain and diarrhea started 2 weeks later, and he was admitted to the hospital for enteritis treatment. Colonoscopy showed multiple ulcerations and petechiae suggestive of vasculitis in the terminal ileum. After prednisolone therapy, his gastrointestinal symptoms improved, but his renal function continued to deteriorate. Based on kidney biopsy findings and nephrotic-range proteinuria (5,306 mg/24 hours), he was diagnosed with anti-neutrophil cytoplasmic autoantibody (ANCA)-negative pauci-immune crescentic GN (CrGN). He received high-dose steroid pulse therapy and oral cyclophosphamide, and then, gradually underwent steroid tapering, with improvement in proteinuria and renal function over several weeks. Several cases of GN suspected to be related to COVID-19 vaccines have been reported. To our knowledge, this is the first case report of ANCA-negative pauci-immune crescentic CrGN with extrarenal involvement after COVID-19 mRNA vaccination. Our finding expands the spectrum of COVID-19 vaccine-associated GN.
Related Concept Videos
01:28Acute Pyelonephritis II: Diagnostic Studies and Management
01:27Acute Pyelonephritis I: Introduction
01:30Acute Pharyngitis
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause:
01:21Myocarditis I: Introduction
01:51Vaccinations
01:24Nephrotic Syndrome I : Introduction