Sex: M
Vaccine: COVID19
Symptoms: Acute kidney injury, Biopsy kidney, Blood albumin, Blood creatinine, Cryoglobulins
Clinical narrative: IMMUNE COMPLEX-MEDIATED GLOMERULONEPHRITIS; ACUTE KIDNEY INJURY (SERUM CREATININE PEAKED AT 5.05 MG/DL); NEPHROTIC SYNDROME (PROTEINURIA, PROGRESSIVE BILATERAL LOWER EXTREMITY EDEMA); This spontaneous report was received from literature: This report concerned a 64 year old male. The objective of this study was to describe de novo or recurrent glomerulonephritis and acute tubulointerstitial nephritis after COVID-19 vaccination in multiple patients. The patient's height, and weight were not reported. The patient's past medical history included: hepatitis C, AKI episodes (acute kidney injury), and orthotropic liver transplant, and concurrent conditions included: alcoholic liver cirrhosis, chronic kidney disease, calcineurin inhibitor toxicity, and hypertension. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of administration not reported, batch number: unknown, expiry: unknown) dose was not reported, 01 total, administered on 12-APR-2021 for prophylactic vaccination. The batch number was not reported and has been requested. Concomitant medications included tacrolimus for immunosuppression.  In MAR-2021, laboratory data included: Protein urine (NR: not provided) No prior quantification, 1 plus proteinuria on urine dipstick, Serum albumin (NR: not provided) 3.6 grams per decilitre (g/dL), and Serum creatinine (NR: not provided) 1.21 Milligrams per decilitre (mg/dl). On 26-APR-2021, the patient experienced acute kidney injury (Serum creatinine peaked at 5.05 mg/dL), nephrotic syndrome (proteinuria, progressive bilateral lower extremity edema). On 07-JUL-2021, the patient had immune complex-mediated glomerulonephritis. On the same day kidney biopsy showed immune complex disease with membranoproliferative glomerulonephritis injury pattern. Diffuse effacement of podocyte foot processes. The majority of glomeruli had mild segmental endocapillary and moderate mesangial hypercellularity. Approximately 10 percent of glomeruli had fibrocellular crescents. The glomeruli capillary walls were thickened with focal segmental duplication. Jones silver stain shows glomerular basement membrane (GBM) duplication × 400 and Glomerular capillary wall IgM immunofluorescence staining. There was focal mild acute tubular injury and up to 50 percent IFTA (interstitial fibrosis/tubular atrophy) with patchy lymphoplasmacytic infiltrates. On an unspecified date, IF (intrinsic factor) showed broad granular stains along the glomerular capillary walls and segmentally in mesangial areas by immunoglobulin A (IgA) (2 plus), immunoglobulin M (IgM) (3  4 plus), C1q (2 plus), C3 (2 plus), kappa (3 plus), and Lambda (3 plus), Albumin was 3.3 g/dL, Cryoglobulins were negative, Electron microscopy numerous subendothelial and scattered mesangial EDD without any sub-ultrastructure and there was diffuse foot-process effacement, Hepatitis C antibody were undetectable, protein urine was 8, 054 milligram/gram (mg/g) (decreased), 30.24 gram (g), No prior quantification, serology test was unremarkable, Serum albumin (NR: not provided) 2.7 g/dL, serum creatinine (NR: not provided) 5.1 mg/dL 1.0  1.3 mg/dl, 5.05 mg/dL 4.3 mg/dL (improved), 2.28 mg/dL (increased). On an unspecified date, Treatment medications included: high-dose of prednisone (60 mg) with slow taper and rituximab 1000 mg 2 weeks apart. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of the acute kidney injury (serum creatinine peaked at 5.05 mg/dl), nephrotic syndrome (proteinuria, progressive bilateral lower extremity edema) and immune complex-mediated glomerulonephritis was not reported.  The authors concluded that they cannot conclusively establish any causal relationship between vaccination and the onset/ re-activation of kidney disease. However, temporal relation between the vaccination and the onset of the symptoms strongly suggests that anomalous immune response to COVID-19 vaccine likely triggered the glomerular/tubulointerstitial injury. This report was serious (Other Medically Important Condition).; Sender's Comments: V0:20220231741-Covid-19 vaccine ad26.cov2.s- acute kidney injury (serum creatinine peaked at 5.05 mg/dl), nephrotic syndrome (proteinuria, progressive bilateral lower extremity edema) , immune complex-mediated glomerulonephritis -The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY, UNDERLYING DISEASE. Therefore, this event(s) is considered not related.