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Glomerular Microangiopathy-like Nephropathy Caused by Hyperthyroidism.

Yuri Katayama1, Naoki Sawa1, Shigekazu Kurihara1

  • 1Department of Nephrology and Okinaka Memorial Institute for Medical Research, Toranomon Hospital Kajigaya, Japan.

Internal Medicine (Tokyo, Japan)
|November 5, 2023
PubMed
Summary

This case study suggests a potential link between COVID-19 vaccination and subsequent hyperthyroidism, which caused kidney damage. Treatment for hyperthyroidism resolved the kidney issues, indicating a possible vaccine-related autoimmune response.

Keywords:
COVID-19 vaccinationTMA-like renal diseaseglomerular microangiopathyhyperthyroidismtamoxifen

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Area of Science:

  • Nephrology
  • Endocrinology
  • Immunology

Background:

  • The coronavirus disease 2019 (COVID-19) vaccine has been associated with various autoimmune phenomena.
  • Hyperthyroidism can present with diverse clinical manifestations, including renal involvement.

Observation:

  • A 49-year-old woman developed nephrotic-range proteinuria, hematuria, and weight loss six months after COVID-19 vaccination.
  • Kidney biopsy revealed thrombotic microangiopathy-like glomerular microangiopathy, predominantly affecting glomerular endothelial cells.
  • The patient was diagnosed with hyperthyroidism, which improved with thiamazole treatment.

Findings:

  • Following hyperthyroidism treatment, proteinuria and hematuria resolved, suggesting a causal relationship.
  • The temporal association between COVID-19 vaccination, hyperthyroidism, and subsequent glomerulopathy is noteworthy.
  • Glomerular endothelial cell damage indicates a potential mechanism for vaccine-induced immune-mediated kidney injury.

Implications:

  • This case highlights the importance of considering COVID-19 vaccination history in patients presenting with new-onset glomerulonephritis and hyperthyroidism.
  • Further research is warranted to elucidate the immunopathogenesis of potential vaccine-associated autoimmune thyroid disease and its renal sequelae.
  • Early diagnosis and management of hyperthyroidism may prevent or reverse vaccine-associated kidney damage.