key: cord-1052369-ppgjzkcw
authors: Obata, Shota; Hidaka, Sumi; Yamano, Mizuki; Yanai, Mitsuru; Ishioka, Kunihiro; Kobayashi, Shuzo
title: MPO-ANCA-associated vasculitis after the Pfizer/BioNTech SARS-CoV-2 vaccination
date: 2021-09-28
journal: Clin Kidney J
DOI: 10.1093/ckj/sfab181
sha: 02d3a13f97d609cb7957d0c3159bae010ce1dea2
doc_id: 1052369
cord_uid: ppgjzkcw

Vaccination against SARS-CoV-2 has demonstrated high efficacy at preventing Coronavirus disease 2019 (COVID-19) and a favorable safety profile, however, it has also been reported that COVID-19 vaccines may put at risk of immune-mediated disease. We herein report a case of MPO-ANCA-associated vasculitis following the mRNA vaccine BNT 162b2 (Pfizer/BioNTech) for COVID-19. Although the causal relationship between vaccine and ANCA-associated vasculitis is uncertain, environmental and genetic factors may have set the stage for the development of vasculitis, and the vaccine may have triggered a domino effect.

Recently, anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis following the COVID-19 vaccines were reported (4) (5), although the causal relationship is uncertain. We herein report a case of MPO-ANCA-associated vasculitis following the mRNA vaccine BNT 162b2 (Pfizer/BioNTech) for COVID-19.

An 84-year-old Japanese man came to our hospital with a two-week lasting spike fever, malaise, and cough after receiving 2 nd BNT 162b2 (Pfizer/BioNTech). No abnormalities had ever been noted on urine tests, and the most recent urine test on December 12th, 2019 was normal. The first and second doses of vaccine were provided on May 22nd, and June 12th, 2021, respectively.

Only a day after the second vaccination, he noticed a headache, low fever, malaise, and cough.

Despite the treatment of loxoprofen sodium, his fever did not resolve and lasted for two weeks.

Cervical lymphadenopathy was also observed at admission. His medical history includes cerebral infarction without sequelae and early colon cancer, which was successfully treated with endoscopic mucosal resection three years before the presentation.

The initial laboratory tests revealed creatinine of 1. 

Efficacy of the BNT162b2 Covid-19 Vaccine in Adolescents

Do COVID-19 RNA-based vaccines put at risk of immune-mediated diseases? In reply to "potential antigenic cross-reactivity between SARS-CoV-2 and human tissue with a possible link to an increase in autoimmune diseases

ANCA-Associated Vasculitis Following the

COVID-19 Vaccine

Moderna COVID-19 vaccination

Nephrotic syndrome and vasculitis following SARS-CoV-2 Vaccine: True association or circumstantial? Nephrol Dial Transplant

The authors thank Naoki Fujiwara and Hiroyuki Suzuki for their critical review of the article.

The authors declared that they have obtained consent from the patient discussed in the report.