Table 2.
Published case reports of GN post AstraZeneca COVID vaccination
| Study | Caza et al.[5] | Morlidge et al.[9]2 cases | Gillion et al.[8] | Villa et al.[10] | Anupama et al.[7] | Leclerc et al.[11] | David et al.[12] | Present case report |
|---|---|---|---|---|---|---|---|---|
| Age (years) | 23 | Case 1: 30 Case 2: 40 |
77 | 63 | 19 | 71 | Case1: 75 Case 2: 74 |
21 |
| Sex | M | Case 1: M Case 2: F |
M | M | F | M | M both | M |
| Symptoms onset post COVID vaccination | 2 weeks post first dose | Case 1: 2 days post first dose Case 2: 1 day post first dose |
4 weeks post first dose | 7 days post first dose | 8 days post first dose | 13 days post first dose | Case 1: 5 weeks post first dose Case 2: 2 weeks post first dose |
12 days post first dose |
| Presentation | NS, AKI | Foamy urine, relapse of MCD Case 1: Post steroid, tacrolimus, rituximab Case 2: Post steroid+tacrolimus |
AKI | Deranged renal function | NS | NS | Old case of Case 1: Renal limited MPA Case 2: No renal involvement prior Both presented with deranged renal function |
NS |
| Serum creatinine | 2.9 mg/dl | Case 1: 0.9 mg/dl, Case 2: 1.18 mg/dl | 2.7 mg/dl | 2.90 mg/dl | 1.09 mg/dl | Oligoanuric AKI requiring hemodialysis Serum creatinine: 10.6 mg/dl |
Peak creatinine Case 1: 7.5 mg/dl Case 2: 9.96 mg/dl |
1.02 mg/dl |
| Proteinuria | 14 g/day | Case 1: UPCR- 142 mg/mmol, Case 2: Urine protein 3+ | Normal | Urine protein 2+ | UPCR: 3.18 | UPCR: 2,312 mg/mmol | 23.87 g/day | |
| Hematuria | Present | No | No | Mild hematuria | No | 6-10 RBCs | Yes | No |
| ANA | Positive | Not done | Negative | Neg | - | - | Negative | |
| ANCA | Negative | Not done | Negative | p ANCA positive | - | p ANCA positive in both | Negative | |
| Renal biospy | MCD | Not done | Noncaseating, non-necrotizing granuloma around small vessels | Focal class of ANCA associated GN | MCD (mesangial proliferative variant) | MCD/AKI | Active crescentic pauci immune GN suggestive of relapse | FSGS (tip variant) |
| Maximum follow-up | 3 weeks | Case 1: 10 days post steroid Case 2: 2 weeks |
4 weeks post steroid | 6 weeks post steroid + cyclophosphamide | Not mentioned | 68 days, off hemodialysis after 38 days | Case 1: RRT+steroid+rituximab Case 2: Steroid+cyclophosphamide |
11 months |
| Response to treatment | Yes | Yes in both cases | Yes. Had also humoral response 8 weeks post vaccination | Yes | Yes | Yes | Case 1: Dialysis-dependent Case 2: Renal dysfunction persists |
No response noted till now to steroid/tacrolimus/rituximab. Humoral response to vaccination noted |
| Follow-up serum creatinine | 1.0 | Same as earlier | Normal creatinine | 2.08 mg/dl | Normal | 1.2 mg/dl | 3.4 mg/dl | 1.02 mg/dl |
| Follow-up proteinuria | UPCR: 0.07 | Normal | Normal | Not mentioned | Normal | UPCR: 28 mg/mmol | - | 20.7 g/day |
NS=Nephrotic syndrome, AKI=Acute kidney injury, UPCR=Urine protein creatinine ratio, MCD=Minimal change disease