Key Points This study identified 29 patients with glomerular disease development in close temporal association with SARS-CoV-2 immunization. Kidney biopsies showed IgA nephropathy, minimal change disease, membranous nephropathy, crescentic GN, and collapsing GN. Patients with de novo collapsing GN in temporal association with SARS-CoV-2 vaccination had two APOL1 genomic risk alleles (high-risk genotype). Visual Abstract Background Immune responses to vaccination are a known trigger for a new onset of glomerular disease or disease flare in susceptible individuals. Mass immunization against SARS-CoV-2 in the COVID-19 pandemic provides a unique opportunity to study vaccination-associated autoimmune kidney diseases. In the recent literature, there are several patient reports demonstrating a temporal association of SARS-CoV-2 immunization and kidney diseases. Methods Here, we present a series of 29 cases of biopsy-proven glomerular disease in patients recently vaccinated against SARS-CoV-2 and identified patients who developed a new onset of IgA nephropathy, minimal change disease, membranous nephropathy, ANCA-associated GN, collapsing glomerulopathy, or diffuse lupus nephritis diagnosed on kidney biopsies postimmunization, as well as recurrent ANCA-associated GN. This included 28 cases of de novo GN within native kidney biopsies and one disease flare in an allograft. Results The patients with collapsing glomerulopathy were of Black descent and had two APOL1 genomic risk alleles. A brief literature review of patient reports and small series is also provided to include all reported cases to date ( n =52). The incidence of induction of glomerular disease in response to SARS-CoV-2 immunization is unknown; however, there was no overall increase in incidence of glomerular disease when compared with the 2 years prior to the COVID-19 pandemic diagnosed on kidney biopsies in our practice. Conclusions Glomerular disease to vaccination is rare, although it should be monitored as a potential adverse event.
【저자키워드】 COVID-19, ANCA, SARS-CoV-2 vaccine, Membranous nephropathy, Collapsing glomerulopathy, APOL1, IgA nephropathy, minimal change disease, lupus nephritis, crescentic glomerulonephritis, glomerular and tubulointerstitial diseases,