key: cord-0739764-n954nayc
authors: Gillion, Valentine; Jadoul, Michel; Demoulin, Nathalie; Aydin, Selda; Devresse, Arnaud
title: Granulomatous vasculitis after the Astra-Zeneca anti-SARS-CoV-2 vaccine.
date: 2021-07-05
journal: Kidney Int
DOI: 10.1016/j.kint.2021.06.033
sha: 004b9cb1e5c1131952ccce5767194d6b23dfe0dd
doc_id: 739764
cord_uid: n954nayc

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Valentine Gillion, MD 1 , Michel Jadoul, MD 1 , Nathalie Demoulin, MD 1 , Selda Aydin, PhD 2 , Several reports of newly diagnosed or relapses of immune-mediated renal diseases following vaccination with anti-SARS-CoV-2 mRNA and Astra-Zeneca vaccines recently emerged in the litterature. 1, 2 We report the case of a 77-year-old male who developed an acute granulomatous nephritis associated with vasculitis after the first dose of the Astra-Zeneca vaccine. The patient had no significant medical history and serum creatinine (SCr) was 1.2 mg/dL a month before vaccination with a protein/creatinine ratio at 0,07 (N=0.15) g/g of creatinine. Four weeks after injection, the patient presented fever, night sweating and anorexia. He was not taking any medication. Laboratory tests revealed acute kidney injury (SCr 2.7 mg/dL), normal proteinuria, no hematuria, and a C-reactive protein (CRP) level of 200 mg/L. Nasopharyngeal swab for SARS-CoV-2 was negative by PCR as were anti-SARS-CoV-2 and ANCA antibodies (repeated twice 15 days apart). Fluorine-18-fluorodeoxyglucose-PET scan showed diffuse hypermetabolism of medium vessels suggesting vasculitis. The kidney biopsy revealed diffuse interstitial oedema with non-caseating non-necrotizing granulomas around small vessels (Figure 1 ), one showing fibrinoid necrosis. There was no immune deposits.

Serum quantiferon for tuberculosis was negative and there were no radiological or biological findings suggestive of sarcoidosis. The patient was started on methylprednisolone with normalisation of SCr and CRP levels within 4 weeks. Interestingly, the patient eventually mounted a humoral response 8 weeks after vaccination.

The association of vasculitis with Influenza and Pertussis vaccines has already been described but without granulomatous pattern. 3 

Relapse of Minimal Change Disease Following the Astra-Zeneca COVID-19 Vaccine

Relapse of IgG4 related nephritis following mRNA Covid vaccine

Vaccine-associated kidney diseases: A narrative review of the literature

Granulomatous interstitial nephritis