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An Efficient Sieving Method to Isolate Intact Glomeruli from Adult Rat Kidney
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Published on: November 1, 2018

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An unusually "complex" glomerulonephritis

Gabriela Martinez-Zayas1, Daniel Savino2, Sumit Kumar3

  • 1Department of Internal Medicine, The University of Texas Southwestern Medical Center, Dallas, Texas.

Proceedings (Baylor University. Medical Center)
|June 27, 2022
PubMed

Insights

A COVID-19 vaccine triggered immune complex-glomerulonephritis in an HIV-positive patient with granulomatosis with polyangiitis. This case highlights vaccine-related immune responses in individuals with chronic HIV.

Area of Science:

  • Nephrology
  • Immunology
  • Infectious Diseases

Background:

  • Granulomatosis with polyangiitis (GPA) is a rare autoimmune disease.
  • mRNA COVID-19 vaccines have been associated with various immune-related adverse events.
  • Human Immunodeficiency Virus (HIV) infection can alter immune responses.

Observation:

  • A 53-year-old male with GPA developed fever and acute kidney injury with nephrotic-range proteinuria after his second mRNA COVID-19 vaccine dose.
  • Renal biopsy showed immune complex-glomerulonephritis (IC-GN) but not vasculitis.
  • Subsequent investigations revealed an underlying HIV infection.

Findings:

  • The patient's presentation suggests a potential link between mRNA COVID-19 vaccination and the development of IC-GN.
  • The immune response to vaccination may have unmasked or exacerbated an underlying HIV infection.
  • This case demonstrates a complex interplay between autoimmune disease, viral infection, and vaccine-induced immunity.

Implications:

  • Further research is needed to understand the mechanisms of vaccine-related glomerulonephritis in immunocompromised individuals.
  • Clinicians should consider underlying infections when evaluating new-onset kidney disease after vaccination.
  • This case underscores the importance of monitoring immune responses to vaccines in patients with chronic conditions like HIV.

Keywords:
COVID vaccineglomerulonephritisgranulomatosis with polyangiitishuman immunodeficiency virusimmune complexestype III hypersensitivity

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