Idiopathic nephrotic syndrome relapse following SARS-CoV-2 vaccination

25 cases (16 men/9 women) presenting a relapse within one month of a COVID-19 vaccine injection are reported in the new issue of Clinical Kidney Journal. It was of childhood onset in half the patients, but all patients were in a stable condition at the time of injection and 11 had no specific treatment. In 5 patients, the last relapse was reported more than five years before vaccine injection. 

The Pfizer-bioNTech vaccine was used in 80% of the patients.  Oxford/AstraZeneca and Moderna vaccines caused relapse in the remaining 20% (3 and 2 cases, respectively).   

Idiopathic Nephrotic Syndrome (INS) is a rare primary glomerular group of diseases characterized by the triad of edema, massive, or nephrotic-range, proteinuria and hypoalbuminemia, for which there is no known cause. In 18 cases, the relapse of NS occurred after the first injection, a mean of 17.5 days after vaccination (range: 7–28 days). No clinical and/or laboratory findings of relapse were reported in the first week after vaccination, seven relapses occurred in the second week, eight in the third week and three in the fourth week. Despite the occurrence of a relapse, all but four patients received a second dose of vaccine of the same type as the first, except for one young patient (patient 1) who was vaccinated with the BNT162b2 vaccine 3 months after an initial AZD1222 vaccine injection (the AZD1222 vaccine was no longer authorized for people <55 years of age in France at the time of his second injection). One of the four patients who received only one dose had a positive polymerase chain reaction test for SARS-CoV-2 at the time at which he should have received the second injection.


REFERENCE

Aurélie Hummel, Julie Oniszczuk, Delphine Kervella, Marina Charbit, Dominique Guerrot, Angelo Testa, Carole Philipponnet, Cécile Chauvet, Thomas Guincestre, Karine Brochard, Ariane Benezech, Lucile Figueres, Xavier Belenfant, Andrea Guarnieri, Nathalie Demoulin, Elisa Benetti, Marius Miglinas, Kathleen Dessaix, Johann Morelle, Andrea Angeletti, Anne-Laure Sellier-Leclerc, Bruno Ranchin, Guillaume Goussard, Laurent Hudier, Justine Bacchetta, Aude Servais, Vincent Audard, Idiopathic nephrotic syndrome relapse following COVID-19 vaccination: a series of 25 cases, Clinical Kidney Journal, Volume 15, Issue 8, August 2022, Pages 1574–1582, https://doi.org/10.1093/ckj/sfac134

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