key: cord-0793324-e4rugrb1
authors: Salem, Fadi; Rein, Joshua; Mon-Wei Yu, Samuel; Abramson, Mathew; Cravedi, Paolo; Chung, Miriam
title: Report of Three Cases of Minimal Change Disease Following the Second Dose of mRNA SARS-CoV-2 Vaccine
date: 2021-07-27
journal: Kidney Int Rep
DOI: 10.1016/j.ekir.2021.07.017
sha: 72be5babcf27f579d3c6c8138cbbad4cec238f96
doc_id: 793324
cord_uid: e4rugrb1

nan

First patient is a 33-year-old woman with a biopsy-proven diagnosis of MCD at 9 years of age, in remission since she was 17. She presented with abrupt lower extremity edema, headaches, nausea, vomiting, and hypertension after 3 weeks of receiving the second dose of the Moderna mRNA-1273 vaccine. Labs revealed nephrotic-range proteinuria (UPCR: 6.4 g/g) with hypoalbuminemia (albumin: 2.3 g/dl). A kidney biopsy showed features consistent with MCD (Figure 1a and 1d) .

Second patient is a 41-year-old woman with a history of asthma and no prior history of kidney disease. Five days after receiving the second dose of the Pfizer BioNTech COVID19 vaccine, she presented with fever, progressive lower extremity swelling, weight gain and hypertension. Labs revealed nephrotic-range proteinuria (UPCR: 14.4 g/g), hypoalbuminemia (albumin: 2.6 g/dl) and hematuria (20 urinary RBCs/hpf.). A kidney biopsy showed features consistent with MCD (Figure 1b and 1e) .

Third patient is a 34-year-old woman with a history of steroid-sensitive MCD at age 4. After 4 weeks of receiving the second dose of Pfizer BioNTech COVID19 vaccine, she developed progressive lower extremity swelling and abdominal pain. Labs revealed nephrotic-range proteinuria (UPCR: 12.9 g/g) and hypoalbuminemia (albumin: 2.8 g/dl). A kidney biopsy showed features consistent with MCD (figure 1c and 1f).

The increasing number of SARS-Cov-2 mRNA vaccine-associated MCD cases reported so far, suggests a causal link and warrants a careful monitoring in patients with glomerular diseases. An in-depth study of the innate and adaptive immune reactions elicited by SARS-CoV-2 mRNA vaccine may provide a unique opportunity to unravel pathogenic mechanisms responsible for these diseases. 

Letter regarding "Minimal change disease relapse following SARS-CoV-2 mRNA vaccine

De Novo and Relapsing Glomerular Diseases After COVID-19 Vaccination: What Do We Know So Far?