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BMC Nephrol . Secondary immunoglobulin A nephropathy with gross hematuria leading to rapidly progressive glomerulonephritis following severe acute r

tetano

Editor, Senior Moderator
BMC Nephrol


. 2023 Aug 8;24(1):232.
doi: 10.1186/s12882-023-03287-y. Secondary immunoglobulin A nephropathy with gross hematuria leading to rapidly progressive glomerulonephritis following severe acute respiratory syndrome coronavirus 2 vaccination: a case report

Miyako Fukuda[SUP] 1 [/SUP], Tomohiro Kaneko[SUP] 2 [/SUP], Takahiro Kawai[SUP] 2 [/SUP], Hiromasa Ishii[SUP] 2 [/SUP], Akira Shimizu[SUP] 3 [/SUP]



Affiliations
Abstract

Background: The 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 presentation: A 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.
Conclusion: SARS-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.

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

 
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