Table 5.
Summary of reported cases of de novo glomerulonephritis or a relapse/flare of the established disease. Additional cases can be entered in the IRoC-GN 2 registry (https://redcapsurvey.niddk.nih.gov/surveys/?s=LCDAMFD9JA)
| Disease | Vaccine platform | Cases reported | De novo or relapse/flare | After 1st or 2nd dose of vaccine | Immunosuppression during vaccination | Management of active disease after vaccination | Outcome (creatinine) |
|---|---|---|---|---|---|---|---|
| MCD | mRNA [27], viral-vectored [7], inactivated whole virus [2] | 36 | De novo [27], relapse [9] | 1st [18], 2nd [11], unknown [7] | Not reported [9], no IS [22], corticosteroids [5], tacrolimus [2] | Corticosteroids [27], rituximab [1], MMF [1], tacrolimus [1], CSA [2] not reported [9] | Unknown [15], worsening [2], stable [5], improving [14] |
| MN | mRNA [9], viral-vectored [1], inactivated whole virus [1] | 11 | De novo [7], relapse [4] | 1st [2]c 2nd [6], unknown [3] | Not reported [7], no IS [4] | Conservative [2], corticosteroids [1], tacrolimus [1], obinutuzumab [1], rituximab [2], not reported [3] | Unknown [6], stable [1], improving [4] |
| FSGSa | mRNA [2], viral-vectored [3] | 5 | De novo [3], relapse [2] | 1st [3], 2nd [2] | Not reported [2], no IS [3] | Conservative [2], corticosteroids [3], rituximab [1], plasma exchange [1], tacrolimus [1] | Worsening [2], stable [1], improving [2] |
| IgAN | mRNA [43], viral-vectored [1], inactivated viral particles [1] | 45 | De novo [26], flare [19] | 1st [9], 2nd [26], unknown [10] | Not reported [15], no IS [29], corticosteroids [1] | Conservative [11], corticosteroids [18], cyclophosphamide [5], tonsillectomy [1], unknown [7] | Unknown [12], worsening [2], stable [15], improving [16] |
| IgAV | mRNA [2] | 2 | De novo [1], flare [1] | 1st [1], 2nd [1] | No IS [2] | Corticosteroids [2] | Improving [2] |
| AAV | mRNA [16], viral-vectored [4] | 20 | De novo [17], relapse [3] | 1st [6], 2nd [9], unknown [5] | Not reported [3], no IS [13], corticosteroids [2], rituximab [1]d | Corticosteroids [18], rituximab [12], cyclophosphamide [9], PLEX [2] | Unknown [3], worsening [4], improving [13] |
| Anti-GBMb[85] | mRNA [4], inactivated whole virus [2], unknown | 7 | De novo [7] | 1st [1], 2nd [6] | Not reported [2], no IS [1] | Corticosteroids [1], MMF [1], cyclophosphamide [5], PLEX [5] | Unknown [2], worsening [2], stable [1], improving [2] |
| LN | mRNA [2], viral-vectored [1] | 3 | De novo [2], relapse [1] | 1st [2], unknown [1] | No IS [3] | Corticosteroids [3], MMF [2] | Unknown [1, stable [1], improving [1] |
| Focal proliferative GN | Viral-vectored [1] | 1 | De novo [1] | 1st [1] | No IS [1] | Corticosteroids [1] | Improving [1] |
| AIN | mRNA [7] | 7 | De novo [7] | 1st [1], 2nd [6] | No IS [7] | Corticosteroids [7] | Improving [7] |
| IgG4-RD | mRNA [1] | 1 | Relapse [1] | 2nd [1] | No IS [1] | Corticosteroids [1], rituximab [1] | Improving [1] |
| SRC | mRNA [1] | 1 | De novo [1] | 1st [1] | No IS [1] | Conservative [1] | Stable [1] |
AIN, acute interstitial nephritis; GBM, glomerular basement membrane; IgAN, IgA nephropathy; IgG4-RD, IgG4-related disease; IS, immunosuppression; LN, lupus nephritis; MN, membranous nephropathy; SRC, scleroderma renal crisis.
aTwo patients after kidney transplantation; one with a de novo case in the allograft.
bIncluding cases with atypical anti-GBM disease [85] and double-positive cases (AAV and anti-GBM disease) [86, 87].
cWorsening proteinuria occurred after administration of the second vaccine dose (switch from BNT162b2 to mRNA-1273).
dLast rituximab as part of maintenance therapy was given 9 months before vaccination.