Sex: F
Vaccine: COVID19
Symptoms: Sarcoidosis, Urinary sediment, Urine protein/creatinine ratio
Clinical narrative: RELAPSE OF MEMBRANOUS NEPHROPATHY; RELAPSE OF RENAL SARCOIDOSIS; This spontaneous report was received from other health professional via literature. This report concerned a 65 year old female of an unspecified race and ethnicity. The objective of the authors were to discuss the role of infectious agents derived antigens including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been recognized as a trigger for development of autoimmune mediated disorders following natural infection or immunization. However, there is a scarcity of reports of occurrence of autoimmune associated kidney disorders or flare ups following exposure to a SARS-CoV-2 vaccine. The patient's height, and weight were not reported. The patient's concurrent conditions included: membranous nephropathy (The patient is well known to have systemic sarcoidosis under complete remission on low dose prednisone and likely membranous nephropathy (no previous kidney biopsy) with mildly elevated phospholipase A2 receptor (PLA2R) antibodies. Her membranous nephropathy was in partial remission on angiotensin receptor blockage, with urine to protein creatinine ratio (UPCR) of 1.5 g/g), and renal sarcoidosis. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number and expiry date were not reported) dose, start therapy date were not reported, 1 total administered for covid-19 prophylaxis. The batch number was not reported. Per procedure, no follow-up will be requested for this case. Concomitant medications included prednisone.  On an unspecified date, 5 months after vaccination, the patient experienced relapse of membranous nephropathy, and relapse of renal sarcoidosis. She was presented to a nephrology clinic for evaluation of worsening renal dysfunction. She started having a flare up of her systemic sarcoidosis with worsening joint, skin and respiratory symptoms. Laboratory data (dates unspecified) included: Creatinine elevated creatinine up to 1.7 mg/dL from her baseline of 1.0 mg/dL, Kidney biopsy showed a combination of membranous nephropathy (PLA2R-Phospholipase A2 Receptor positive) along with granulomatous interstitial nephritis with well-formed epithelioid granulomas characteristic of sarcoidosis, Urinary sediment revealed no red blood cells or casts, only several calcium oxalate dihydrate crystals, and Urine protein/creatinine ratio elevated at 3.4 g/g. Treatment medications (dates unspecified) included: prednisone. After treating with high dose prednisone, her renal function improved to 1.2 mg/dL, Urine protein/creatinine ratio decreased to 1.8 g/g and serum PLA2R antibodies became undetectable. She was still being monitored. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from relapse of membranous nephropathy, and relapse of renal sarcoidosis. The authors concluded that after many years of renal sarcoidosis and membranous nephropathy remission, the relapse of renal disease after receiving the SARS-CoV-2 vaccine (Johnson & Johnson) suggests the association between receiving the vaccine and the recurrence of renal sarcoidosis and membranous nephropathy. This report was serious (Other Medically Important Condition).; Sender's Comments: V0:20220912367-Covid-19 vaccine ad26.cov2.s- relapse of membranous nephropathy,  relapse of renal sarcoidosis. 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. Therefore, this event(s) is considered not related.