Age: 82.0
Sex: F
Vaccine: COVID19
Symptoms: Anti-neutrophil cytoplasmic antibody positive vasculitis, Biopsy kidney, Blood creatinine, Glomerulonephritis rapidly progressive, Protein urine
Clinical narrative: MPO-ANCA associated vasculitis; Pauci-immune crescentic GN; This literature-non-study case was reported in a literature article and describes the occurrence of ANTI-NEUTROPHIL CYTOPLASMIC ANTIBODY POSITIVE VASCULITIS (MPO-ANCA associated vasculitis) and GLOMERULONEPHRITIS RAPIDLY PROGRESSIVE (Pauci-immune crescentic GN) in an 82-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination.      No Medical History information was reported.    On an unknown date, the patient received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date,  after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced ANTI-NEUTROPHIL CYTOPLASMIC ANTIBODY POSITIVE VASCULITIS (MPO-ANCA associated vasculitis) (seriousness criterion medically significant) and GLOMERULONEPHRITIS RAPIDLY PROGRESSIVE (Pauci-immune crescentic GN) (seriousness criterion medically significant). The patient was treated with RITUXIMAB for Vasculitis, at an unspecified dose and frequency and PREDNISONE for Vasculitis, at an unspecified dose and frequency. At the time of the report, ANTI-NEUTROPHIL CYTOPLASMIC ANTIBODY POSITIVE VASCULITIS (MPO-ANCA associated vasculitis) and GLOMERULONEPHRITIS RAPIDLY PROGRESSIVE (Pauci-immune crescentic GN) was resolving.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Biopsy kidney: abnormal kidney biopsy was done which revealed pauci-immune crescentic GN.. On an unknown date, Blood creatinine: 0.8 mg/dl Baseline SCr 0.8 mg/dl, 2.5 mg/dl Laboratories during presentation 2.5 Serum creatinine peaked at 3.1 mg/dL and 2..3 mg/dl Laboratories during last follow-up 2.3 mg/dl. On an unknown date, Protein urine: 1.2 g/d Laboratories during presentation 1.2 g/d. On an unknown date, Red blood cells urine: 3-10 high power field(hpf) Laboratories during presentation 3-10 HPF.     For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter considered ANTI-NEUTROPHIL CYTOPLASMIC ANTIBODY POSITIVE VASCULITIS (MPO-ANCA associated vasculitis) and GLOMERULONEPHRITIS RAPIDLY PROGRESSIVE (Pauci-immune crescentic GN) to be possibly related.    Our patient presented with shortness of breath and fatigue 4 weeks after the 2nd dose. The patient was found to have Acute kidney injury, hematuria and proteinuria. Patient was diagnosed with myeloperoxidase-antineutrophilic cytoplasmic antibody (MPO-ANC) associated vasculitis. Patient was treated with High-dose steroid.  This case concerns a 82-year-old female patient with no previous relevant medical history, who experienced the unexpected serious event of Anti-neutrophil cytoplasmic antibody positive vasculitis and Pauci-immune glomerulonephritis after Spikevax (mRNA- 1273 vaccine / Moderna COVID-19 Vaccine). The events occurred approximately 4 weeks after the second dose of Spikevax. Clinical manifestations included dyspnoea and fatigue. Laboratory results showed acute kidney injury with rapid increase of creatinine up to 3.1mg/dl, microscopic haematuria and subnephrotic range proteinuria. Kidney biopsy showed pauci-immune crescentic glomerulonephritis. Treatment with rituximab and high dose prednisone was given. At the time of the report, creatinine was improving (2.3mg/dl) The rechallenge is not applicable, since the event was reported exclusively after the second dose. The benefit-risk relationship of Spikevax vaccine is not affected by this report.   This case was linked to MOD-2021-357261, MOD-2021-357609, MOD-2021-357610, MOD-2021-357612, MOD-2021-357613, MOD-2021-357614 (Patient Link).   Most recent FOLLOW-UP information incorporated above includes: On 20-Oct-2021: Follow up received by safety 22-Oct-2021 included an Email with received from team and does not contain any new information; Sender's Comments: This case concerns a 82-year-old female patient with no previous relevant medical history, who experienced the unexpected serious event of Anti-neutrophil cytoplasmic antibody positive vasculitis and Pauci-immune glomerulonephritis after Spikevax (mRNA- 1273 vaccine / Moderna COVID-19 Vaccine). The events occurred approximately 4 weeks after the second dose of Spikevax. Clinical manifestations included dyspnoea and fatigue. Laboratory results showed acute kidney injury with rapid increase of creatinine up to 3.1mg/dl, microscopic haematuria and subnephrotic range proteinuria. Kidney biopsy showed pauci-immune crescentic glomerulonephritis. Treatment with rituximab and high dose prednisone was given. At the time of the report, creatinine was improving (2.3mg/dl) The rechallenge is not applicable, since the event was reported exclusively after the second dose. The benefit-risk relationship of Spikevax vaccine is not affected by this report.