Acute Interstitial Nephritis with Glomerular Capillary IgA Deposition Following SARS-CoV-2 mRNA Vaccination

Intern Med. 2023;62(16):2381-2387. doi: 10.2169/internalmedicine.1631-23. Epub 2023 Aug 15.

Abstract

We herein report a case of acute kidney injury (AKI) presenting as acute interstitial nephritis (AIN) after the first dose of the BNT162b2 mRNA vaccine against coronavirus disease 2019 (COVID-19). A 69-year-old man with a history of diabetes and hypertension presented with AKI 4 days after receiving the vaccine. Despite the administration of methylprednisolone pulse treatment, his renal function worsened, which prompted us to initiate temporal hemodialysis. His renal function subsequently improved, and a renal biopsy confirmed AIN and glomerular capillary IgA deposition without apparent crescents. The clinical history and histological findings suggest a relationship between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination and AIN as a rare side effect.

Keywords: COVID-19; SARS-CoV-2; acute interstitial nephritis; acute kidney injury; capillary IgA deposition; vaccination.

Publication types

  • Case Reports

MeSH terms

  • Acute Kidney Injury* / etiology
  • Aged
  • BNT162 Vaccine* / adverse effects
  • COVID-19 / prevention & control
  • Humans
  • Immunoglobulin A
  • Male
  • Nephritis, Interstitial* / etiology
  • RNA, Messenger
  • Vaccination / adverse effects

Substances

  • BNT162 Vaccine
  • Immunoglobulin A
  • RNA, Messenger

Supplementary concepts

  • Acute Tubulointerstitial Nephritis