The rare and severe adverse effects associated with coronavirus disease of 2019 (COVID-19) vaccination have been under-appreciated, resulting in many instances of inappropriate management. We describe the case of an elderly woman who developed anti-neutrophil cytoplasmic antibody-associated vasculitis with pulmonary renal syndrome approximately 3 weeks after the first dose of COVID-19 mRNA vaccination (Moderna). Her nasopharyngeal polymerase chain reaction test for the COVID-19 RNA virus was negative. Gross hematuria, heavy proteinuria, acute renal failure (serum creatinine up to 6.5 mg/dL), and hemoptysis coupled with a marked increase in serum anti-myeloperoxidase-O antibody were observed. Renal biopsy showed severe vasculitis with pauci-immune crescent glomerulonephritis. The pulmonary hemorrhage was resolved and renal function improved following combined plasma exchange and the administration of systemic steroids and anti-CD20 therapy. The early examination of urinalysis and renal function may be crucial for identifying glomerulonephritis and acute renal failure in susceptible patients after COVID-19 vaccination.
【저자키워드】 COVID-19, vaccination, Vasculitis, anti-neutrophil cytoplasmic antibody (ANCA), pulmonary renal syndrome, 【초록키워드】 coronavirus disease, antibody, renal function, anti-CD20 therapy, serum, Urinalysis, COVID-19 vaccination, nasopharyngeal, management, Systemic steroid, plasma, RNA virus, renal biopsy, Moderna, administration, acute renal failure, gross hematuria, COVID-19 mRNA Vaccination, serum creatinine, first dose, syndrome, renal, pulmonary hemorrhage, hemoptysis, polymerase chain, resulting, cytoplasmic, increase in, instance, resolved, severe adverse effect, susceptible patient, 【제목키워드】 pulmonary, failure,