Sex: F
Vaccine: FLUX
Symptoms: Biopsy kidney abnormal, Blister, Chronic kidney disease, Cushingoid, Glomerulonephritis minimal lesion
Clinical narrative: foaming of the urine; severe edema of the legs; Minimal change disease; Chronic kidney disease (CKD stage 2); This case was reported in a literature article and described the occurrence of minimal change disease in a adult female patient who received Flu unspecified (Influenza vaccine) for prophylaxis.  Concurrent medical conditions included hypertension.   On an unknown date, the patient received Influenza vaccine. In June 2018, 15 days after receiving Influenza vaccine, the patient experienced minimal change disease (serious criteria GSK medically significant) and chronic kidney disease (serious criteria GSK medically significant). On an unknown date, the patient experienced foamy urine and leg edema. The patient was treated with prednisone. On an unknown date, the outcome of the minimal change disease, chronic kidney disease, foamy urine and leg edema were recovering/resolving.   The reporter considered the minimal change disease, chronic kidney disease, foamy urine and leg edema to be probably related to Influenza vaccine.     Additional Information: GSK Receipt Date: 17-JUN-2022 Author Comment: The patient's age was 54 years at the time of reporting. The patient was had a medical history of hypertension. The patient provided informed verbal consent for her case to be presented. In 2018, the patient received Influenza vaccine. She was initially diagnosed with minimal change disease (MCD) in June 2018, approximately 15 days after receiving the influenza vaccine. The initial presenting symptoms included foaming of the urine and severe edema of the legs. The diagnosis was made following a kidney biopsy. After a course of prednisone therapy, she remained in remission for 4 months. However, she relapsed in October 2018 and was deemed to be in remission after being treated with prednisone the second time. She was tapered off the prednisone over the next 3 months, after a 6 months taper was originally planned. However, the patient experienced moon facies and blistering skin as adverse effects of taking steroids, so she requested a shorter taper period. She was diagnosed with chronic kidney disease (CKD stage 2) after the first episode of MCD. She remained in remission for over 3 years following treatment with steroids. She did not receive the influenza vaccine or any other vaccine during the time she was in remission because she was concerned about a relapse. She chose to receive the Pfizer vaccine against COVID-19 because she worked in healthcare and had reactivation of MCD after receiving the Pfizer vaccine.  The development of MCD has also been reported after influenza, hepatitis B, pneumococcal, measles, and tetanus-diphtheria-poliomyelitis vaccines. There have been various cases of reactivation of MCD after the administration of the influenza vaccine. The exact pathogenesis of MCD following influenza vaccination is not known; however, it is plausible for immune complexes to form or deposit in the subepithelial space because of the interaction between the influenza vaccine antigen and native antibodies, leading to this pathological process.