Atypical Anti-Glomerular Basement Membrane Nephritis After the First Dose of the Severe Acute Respiratory Syndrome Coronavirus 2 mRNA Vaccine

by Selleckchem | Oct 13 2023

Atypical anti-glomerular basement membrane (GBM) nephritis is a slowly progressive characterized by linear deposition of immunoglobulin (Ig) G in the GBM without circulating anti-GBM antibodies or lung involvement. There is no established therapy for this disease, and efficacy of the immunosuppressive treatment is questionable. A few cases of atypical anti-GBM nephritis have been reported after administration of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine. Classic anti-GBM disease has also been reported after the administration of the second dose of the SARS-CoV-2 vaccine. Herein, we present the case of a SARS-CoV-2 vaccine-induced atypical anti-GBM nephritis that developed after the first dose and was unresponsive to immunosuppressive therapy. A 57-year-old Japanese woman developed edema 11 days after the first dose of the SARS-CoV-2 mRNA vaccine. She developed nephrotic-range proteinuria and microscopic hematuria. Renal biopsy revealed endocapillary proliferative glomerulonephritis with linear IgG deposition. However, electron-dense deposits were not detected on electron microscopy. The patient tested negative for circulating anti-GBM antibodies and was diagnosed with atypical anti-GBM nephritis. Although steroids and mizoribine were administered, the patient's renal function deteriorated. In conclusion, atypical anti-GBM nephritis may have earlier onset than the classic anti-GBM disease. Given its uncertainty of effectiveness, immunosuppressive agents should be carefully used for SARS-CoV-2 mRNA vaccine-induced atypical anti-GBM nephritis.

Comments:

I'm not a doctor, but I can try to provide some information based on the description you provided. Atypical anti-glomerular basement membrane (GBM) nephritis is a rare kidney disease characterized by the linear deposition of immunoglobulin G (IgG) in the GBM without the presence of circulating anti-GBM antibodies or lung involvement. It is considered a slowly progressive condition.

There have been a few reported cases of atypical anti-GBM nephritis occurring after administration of the SARS-CoV-2 mRNA vaccine. Additionally, classic anti-GBM disease has also been reported after the administration of the second dose of the SARS-CoV-2 vaccine.

In the case you mentioned, a 57-year-old woman developed edema, nephrotic-range proteinuria (excessive protein in the urine), and microscopic hematuria (blood in the urine) 11 days after receiving the first dose of the SARS-CoV-2 mRNA vaccine. A renal biopsy revealed endocapillary proliferative glomerulonephritis (a type of kidney inflammation) with linear IgG deposition. However, electron-dense deposits, which are typically seen in classic anti-GBM disease, were not detected on electron microscopy. The patient tested negative for circulating anti-GBM antibodies, leading to a diagnosis of atypical anti-GBM nephritis.

The patient was treated with steroids and mizoribine, which are immunosuppressive agents commonly used in the treatment of autoimmune kidney diseases. However, despite the treatment, the patient's renal function deteriorated.

It's important to note that this is a single case report, and each individual case may vary. The effectiveness of immunosuppressive therapy for SARS-CoV-2 vaccine-induced atypical anti-GBM nephritis is uncertain, and further research and clinical experience are needed to establish appropriate treatment strategies.

If you or someone you know is experiencing similar symptoms or concerns, it's important to consult a healthcare professional for an accurate diagnosis and appropriate management. They will be able to provide personalized medical advice based on the individual's specific situation.