IgA Nephropathy After SARS-CoV-2 Vaccination

Here we present the first case of newly diagnosed IgA nephropathy (IgAN) after a SARS-CoV-2 vaccination. A 30-year-old man with no known past medical history presented with gross hematuria and subnephrotic proteinuria 24 hours after the second dose of the mRNA-1273 SARS-CoV-2 vaccine. A kidney biops...

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Main Authors: Matthew Abramson, Samuel Mon-Wei Yu, Kirk N. Campbell, Miriam Chung, Fadi Salem
Format: Article
Language:English
Published: Elsevier 2021-09-01
Series:Kidney Medicine
Online Access:http://www.sciencedirect.com/science/article/pii/S2590059521001552
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author Matthew Abramson
Samuel Mon-Wei Yu
Kirk N. Campbell
Miriam Chung
Fadi Salem
author_facet Matthew Abramson
Samuel Mon-Wei Yu
Kirk N. Campbell
Miriam Chung
Fadi Salem
author_sort Matthew Abramson
collection DOAJ
description Here we present the first case of newly diagnosed IgA nephropathy (IgAN) after a SARS-CoV-2 vaccination. A 30-year-old man with no known past medical history presented with gross hematuria and subnephrotic proteinuria 24 hours after the second dose of the mRNA-1273 SARS-CoV-2 vaccine. A kidney biopsy showed IgAN. He was started on an angiotensin receptor blocker, resulting in proteinuria reduction. Similar to natural infection of SARS-CoV-2, persons who receive 2 mRNA-based vaccines demonstrate robust antibodies against the receptor-binding domain (RBD) of the S1 protein. Given the uniqueness of glycosylation of RBD and potent stimulation of immune response from mRNA-based vaccine compared to other vaccines, we hypothesize that our patient developed de novo antibodies, leading to IgA-containing immune-complex deposits. This case highlights the urgency of understanding the immunological responses to novel mRNA-based SARS-CoV-2 vaccines in more diverse populations. Despite the lack of clear causality, nephrologists should be alerted if any new-onset hematuria or proteinuria is observed.
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spelling doaj.art-d09f04c7f8ce4844b1d7eb7ec6e9fdc52022-12-21T21:31:12ZengElsevierKidney Medicine2590-05952021-09-0135860863IgA Nephropathy After SARS-CoV-2 VaccinationMatthew Abramson0Samuel Mon-Wei Yu1Kirk N. Campbell2Miriam Chung3Fadi Salem4Division of Nephrology Icahn School of Medicine at Mount Sinai, New York, New York; Address for Correspondence: Matthew Abramson, MD, Icahn School of Medicine at Mount Sinai, 5 East 98th St, 11th Floor, New York, NY 10029-6574.Division of Nephrology Icahn School of Medicine at Mount Sinai, New York, New YorkDivision of Nephrology Icahn School of Medicine at Mount Sinai, New York, New YorkDivision of Nephrology Icahn School of Medicine at Mount Sinai, New York, New YorkDepartment of Pathology, Molecular & Cell Based Medicine, Icahn School of Medicine at Mount Sinai, New York, New YorkHere we present the first case of newly diagnosed IgA nephropathy (IgAN) after a SARS-CoV-2 vaccination. A 30-year-old man with no known past medical history presented with gross hematuria and subnephrotic proteinuria 24 hours after the second dose of the mRNA-1273 SARS-CoV-2 vaccine. A kidney biopsy showed IgAN. He was started on an angiotensin receptor blocker, resulting in proteinuria reduction. Similar to natural infection of SARS-CoV-2, persons who receive 2 mRNA-based vaccines demonstrate robust antibodies against the receptor-binding domain (RBD) of the S1 protein. Given the uniqueness of glycosylation of RBD and potent stimulation of immune response from mRNA-based vaccine compared to other vaccines, we hypothesize that our patient developed de novo antibodies, leading to IgA-containing immune-complex deposits. This case highlights the urgency of understanding the immunological responses to novel mRNA-based SARS-CoV-2 vaccines in more diverse populations. Despite the lack of clear causality, nephrologists should be alerted if any new-onset hematuria or proteinuria is observed.http://www.sciencedirect.com/science/article/pii/S2590059521001552
spellingShingle Matthew Abramson
Samuel Mon-Wei Yu
Kirk N. Campbell
Miriam Chung
Fadi Salem
IgA Nephropathy After SARS-CoV-2 Vaccination
Kidney Medicine
title IgA Nephropathy After SARS-CoV-2 Vaccination
title_full IgA Nephropathy After SARS-CoV-2 Vaccination
title_fullStr IgA Nephropathy After SARS-CoV-2 Vaccination
title_full_unstemmed IgA Nephropathy After SARS-CoV-2 Vaccination
title_short IgA Nephropathy After SARS-CoV-2 Vaccination
title_sort iga nephropathy after sars cov 2 vaccination
url http://www.sciencedirect.com/science/article/pii/S2590059521001552
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