Sibling cases of gross hematuria and newly diagnosed IgA nephropathy following SARS-CoV-2 vaccination

• Published in: BMC nephrology Vol. 23; no. 1; pp. 1 - 216
• Main Authors: Uchiyama, Yuri, Fukasawa, Hirotaka, Ishino, Yuri, Nakagami, Daisuke, Kaneko, Mai, Yasuda, Hideo, Furuya, Ryuichi
• Format: Journal Article
• Language: English
• Published: London BioMed Central Ltd 21-06-2022; BioMed Central; BMC
• Subjects: Analysis; Biopsy; Blood pressure; Body temperature; Brothers and sisters; Care and treatment; Case Report; Coronaviruses; COVID-19; COVID-19 vaccines; Creatinine; Diagnosis; Family medical history; Genetic aspects; Glomerulonephritis; Gross hematuria; Health aspects; Hematuria; IgA glomerulonephritis; IgA nephropathy; Immune response; Immunization; Immunoglobulin A; Immunoglobulins; Infections; Kidney diseases; Laboratories; Morphology; mRNA; Nephrology; Patients; Prevention; Risk factors; SARS-CoV-2 vaccination; Severe acute respiratory syndrome coronavirus 2; Sibling; Tomography; Urinalysis; Vaccines; Japan
• ISSN: 1471-2369; 1471-2369
• DOI: 10.1186/s12882-022-02843-2

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination has become a major part of the strategy to reduce Coronavirus disease 2019 (COVID-19) numbers worldwide. To date, vaccinations based on several mechanisms have been used clinically, although relapse of existent glomerulonephritis presenting as gross hematuria, and occurrence of de novo glomerulonephritis have been reported. Case presentation We report the first sibling cases newly diagnosed as immunoglobulin A (IgA) nephropathy after the second dose of SARS-CoV-2 vaccination. 15- and 18-year-old men presented with gross hematuria following the second dose of SARS-CoV-2 vaccine (Pfizer, BNT162b2) received on the same day. Pathological findings of each kidney biopsy specimen were consistent with IgA nephropathy. Gross hematuria in both cases spontaneously recovered within several days. Conclusions These cases indicate that SARS-CoV-2 vaccination might trigger de novo IgA nephropathy or stimulate its relapse, and also highlight the necessity of understanding the immunological responses to the novel mRNA vaccines in patients with kidney diseases. Keywords: COVID-19, Gross hematuria, IgA nephropathy, SARS-CoV-2 vaccination, Sibling