key: cord-1021118-sorc53uk
authors: Schwotzer, Nora; Kissling, Sébastien; Fakhouri, Fadi
title: Letter regarding “Minimal change disease relapse following SARS-CoV-2 mRNA vaccine”
date: 2021-05-27
journal: Kidney Int
DOI: 10.1016/j.kint.2021.05.006
sha: 2725e4eef49b4d63f36f537db2a1bb6c5ee3fab2
doc_id: 1021118
cord_uid: sorc53uk

nan

Letter to the editor.

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

We read with interest the report by Kervella and al[1] on a patient with minimal change disease (MCD) who experienced a relapse of her nephrotic syndrome following SARS-CoV-2 mRNA vaccine.

We would like to report a similar observation. A 22-year-old adult male patient has been followed in our department since 2019 for an idiopathic nephrotic syndrome due to MCD. His disease proved to be cortico-dependent and he had three relapses of his nephrotic syndrome requiring prolonged corticosteroids treatment and tacrolimus administration. He experienced his third relapse in 12.2020 ( Figure) while receiving no corticosteroids, and during a phase of progressive tacrolimus withdrawal. Complete remission was achieved with increased corticosteroids dosage and tacrolimus reintroduction. Treatment with rituximab was decided but was delayed in order to allow anti-Covid19 vaccination. The patient was advised to monitor proteinuria, using urinary dipsticks, more closely after vaccination.

Three days after receiving SARS-CoV2 mRNA vaccine (BNT162b2, Pfizer R ), he presented with a severe nephrotic syndrome relapse (serum albumin, 23 g/L) and persistently normal kidney function (creatinine 71mol/l) (Figure) . He reported having experienced chills and low-grade fever in the 48h following vaccination and positive proteinuria (2+/3+) on dipsticks as early as 36h after the injection. Prednisone dosage was increased to 20mg/day and subsequently to 60 mg/day, tacrolimus was maintained at 1 mg twice daily but remission was not obtained until 17 days after treatment regimen modification. Subsequently, corticosteroids dosage was progressively decreased to 

Minimal Change Disease relapse following SARS-CoV2 mRNA vaccine

Vaccinations in children on immunosuppressive medications for renal disease