Age: 40.0
Sex: M
Vaccine: COVID19
Symptoms: Focal segmental glomerulosclerosis, Immunology test, Microscopy, Physical examination, Protein urine
Clinical narrative: TIP VARIANT OF FOCAL SEGMENTAL GLOMERULOSCLEROSIS (FSGS); This spontaneous report was received from literature. This report concerned a 45 year old male. The objective of this study was to describe tip variant of focal segmental glomerulosclerosis post COVID-19 vaccination with one case report. The patient's height, and weight were not reported. The patient's pre-existing medical conditions included: Patient had no past medical history. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin, and batch number were not reported, expiry: unknown) dose, start therapy date were not reported, 1 total administered for covid-19 prophylaxis. Age at time of vaccination 5 decade old. The batch number was not reported. Per procedure, no follow-up will be requested for this case. No concomitant medications were reported.  On an unspecified date, 1 week after receiving vaccine, the patient presented with progressive worsening lower extremity edema. He was not taking any prescribed or over the counter medications. His physical exam showed BP (blood pressure) of 160/90 mmHg and plus 2 lower extremity edema. Laboratory studies revealed that, BUN (blood urea nitrogen) 97 mg/dL, serum creatinine 6.7 mg/dL (baseline 0.8 mg/ dL), serum albumin 1.8 g/dL and 24-hour urine protein of 6.5 g. Serological workup was negative. A kidney biopsy showed focal areas of segmental glomerulosclerosis (FSGS), associated with endocapillary foam cells and epithelial cell capping, predominantly involving the takeoff point of the proximal tubule. The areas of segmental sclerosis herniated into the proximal tubule. Immunofluorescence was negative and electron microscopy revealed diffuse epithelial foot process effacement. The patient was diagnosed with tip variant of FSGS (focal segmental glomerulosclerosis) and started on oral prednisone 80 mg daily. He required initiation of dialysis and has no evidence of renal recovery to date. Treatment medications (dates unspecified) included: prednisone. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient had not recovered from tip variant of focal segmental glomerulosclerosis (FSGS). The authors emphasized on new cases and relapses of GN's (glomerulonephritis) can present shortly after mRNA COVID-19 vaccination. IgA nephropathy, FSGS and minimal change disease have been reported. The tip variant of FSGS usually presents as a primary podocytopathy and had the best prognosis among the various forms of FSGS due to its high response to steroid therapy and low risk of progression. This report was serious (Other Medically Important Condition). This case, from the Others is linked to 20221220276.; Sender's Comments: V0- 20221218638- A tip variant of focal segmental glomerulosclerosis-The event has an unknown/unclear temporal relationship, is unlabeled, and is scientifically plausible. There is no information on any other factors potentially associated with the event. Therefore, the Agency Causality is considered indeterminate. The company causality is considered related.