Table 1.
AAV with RPGN following COVID-19 vaccination.
| No | Age/Sex | Past Hx | COVID-19 vaccination | Onset | Symptoms | Urinalysis | Blood test | ANCA type | Kidney Bx | Extra-renal involvement | Treatment | Outcome |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 18 | 52/M | HTN | Moderna | 2 weeks after 2nd dose | Headache Weakness | Dysmorphic RBC | SCr:8.4 mg/dL, | Anti-PR3 (+) | Pauci-immune necrotizing and crescentic GN | None | Hemodialysis Rituximab CYC | Dialysis-dependent |
| 29 | 81/M | Healthy | Moderna | Shortly after 2nd dose | Flu-like symptoms | NA | AKI | Anti-PR3 (+) | Pauci-immune crescentic GN with capillary necrosis & vasculitis | Pulmonary necrotic masses | Plasma exchange Pulse steroid CYC | Improved renal function |
| 310 | 77/M | Healthy | AstraZeneca | 4 weeks after 1st dose | Fever, Night sweating, Anorexia |
NA | SCr:2.7 mg/dL, CRP: 20 mg/dL | NA | Non-caseating, non-necrotizing granuloma | None | Pulse steroid | Resolved renal function |
| 411 | 78/F | DM, HTN | Pfizer-BioNTech | Immediate after 2nd dose | Nausea, vomiting, diarrhea, lethargy | Dysmorphic RBC UACR:2,050 mg/g | SCr:3.5 mg/dL, | Anti-MPO (+) | Necrotizing crescentic GN | None | Rituximab | Improved renal function(SCr: 1.7mg/dL) |
| 512 | 29/F | Congenital cystic lung disease | Pfizer-BioNTech | 7 weeks after 2nd dose | NA | HematuriaUACR:633 mg/g | SCr: 1.9 mg/dL | Anti-MPO (71 AU/ml) | Pauci-immune crescent GN | Chronic lung infiltration | Pulse steroid Rituximab CYC | Improved renal function(SCr: 1.0 mg/dL) |
| 613 | 63/M | Healthy | AstraZeneca | 1 week after 1st dose | Hemoptysis Flu-like symptoms | Microscopic hematuria | SCr:2.9 mg/dL | Anti-MPO (12 IU/ml) | Focal class of pauci-immune crescent GN | Infiltration over LLL | Pulse steroid | Improved renal function(SCr: 2.1 mg/dL) |
| 714 | 79/F | HTN | Pfizer-BioNTech | 2 weeks after 2nd dose | Weakness Upper thigh pain | HematuriaUPCR: >18,000 mg/gUACR <5,000 mg/g |
SCr: 6.57 mg/dL Eosinophils: 23.3% |
Anti-MPO (>134 IU/ml) | Vasculitis with pauci-immune crescent GN | CK: 14,243 U/LMyoglobinemia >12,000 μg/L | Pulse steroid CYC | Resolved renal function |
| 8 | 70/F | UTI | Moderna | 3 weeks after 1st dose | Headache Hemoptysis Hematuria | Dysmorphic RBCUPCR:4,384 mg/g | SCr:3.5 mg/dL CRP:2.7 mg/dL |
Anti-MPO (378 IU/ml) | Vasculitis with pauci-immune crescent GN | Pulmonary vasculitis | Plasma exchange Pulse steroid Rituximab | Improved renal function(SCr: 2.5 mg/dL) |
CYC, Cyclophosphamide, Hx, history, Bx, biopsy, NA, Not applicable, PR3, proteinase 3, ANCA, anti-neutrophil cytoplasmic antibody, HTN, hypertension, DM, diabetes mellitus, SCr, serum creatinine, GN, glomerulonephritis, UPCR, urine protein creatinine ratio, CKD, chronic kidney disease, CRP, C-Reactive protein, LLL, left lower lung.