A Case of Acute Interstitial Nephritis After Two Doses of the BNT162b2 SARS-CoV-2 Vaccine

Filipe S Mira,1,2,* Jóni Costa Carvalho,3,* Patrícia Amaral de Almeida,4 Ana Carolina Pimenta,1 Iolanda Alen Coutinho,3 Carolina Figueiredo,1 Luís Rodrigues,1,2 Vítor Sousa,2,5 Emanuel Ferreira,1,2 Helena Pinto,1,2 Luís Escada,1,2 Ana Galv&a...

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Autores principales: Mira FS, Costa Carvalho J, Almeida PA, Pimenta AC, Alen Coutinho I, Figueiredo C, Rodrigues L, Sousa V, Ferreira E, Pinto H, Escada L, Galvão A, Alves R
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Publicado: Dove Medical Press 2021
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spelling oai:doaj.org-article:65f4e2c8601a4041b21cef91d526169b2021-12-05T18:27:45ZA Case of Acute Interstitial Nephritis After Two Doses of the BNT162b2 SARS-CoV-2 Vaccine1178-7058https://doaj.org/article/65f4e2c8601a4041b21cef91d526169b2021-12-01T00:00:00Zhttps://www.dovepress.com/a-case-of-acute-interstitial-nephritis-after-two-doses-of-the-bnt162b2-peer-reviewed-fulltext-article-IJNRDhttps://doaj.org/toc/1178-7058Filipe S Mira,1,2,* Jóni Costa Carvalho,3,* Patrícia Amaral de Almeida,4 Ana Carolina Pimenta,1 Iolanda Alen Coutinho,3 Carolina Figueiredo,1 Luís Rodrigues,1,2 Vítor Sousa,2,5 Emanuel Ferreira,1,2 Helena Pinto,1,2 Luís Escada,1,2 Ana Galvão,1,2 Rui Alves1,2 1Nephrology Department, Coimbra University Hospital, Coimbra, Portugal; 2Coimbra University Faculty of Medicine, Coimbra, Portugal; 3Allergy and Clinical Immunology Department, Coimbra University Hospital, Coimbra, Portugal; 4Internal Medicine Department, Figueira da Foz Hospital, Figueira da Foz, Portugal; 5Pathological Anatomy Department, Coimbra University Hospital, Coimbra, Portugal*These authors contributed equally to this workCorrespondence: Filipe S Mira Rua Alfredo Lopes Xisto, nº 36, Coimbra, 3000-020, PortugalTel +351 932463036Email filipemira@netcabo.ptBackground: The development of vaccines to prevent COVID-19 breakouts came with highly positive results but some unexpected side effects. Rare side effects have been seen with the BNT162b2 SARS-CoV 2 vaccine.Case Presentation: We present the case of a 45-year-old female patient who developed an acute kidney injury needing urgent hemodialysis one week after the second administration of the BNT162b2 SARS-CoV 2 vaccine. She developed a macular rash on her lower limbs and palms as well. A kidney biopsy was performed 10 days after vaccine inoculation, diagnosing acute interstitial nephritis and acute tubular necrosis with cellular casts. The patient was treated with three corticosteroid pulses followed by daily prednisolone. We witnessed clinical improvement 4 days after the initial corticosteroid treatment with progressive recovery of kidney function and hemodialysis withdrawal. After 2 weeks, the patient had recovered her kidney function. Immunophenotyping was performed, diagnosing a hypersensitivity to the vaccine and the polyethylene glycol excipient.Conclusion: Patients may develop acute reactions to vaccines. In this case, symptoms seem to correlate significantly with its inoculation and, although this case had a favourable outcome, these side effects must be made aware for clinicians and patients.Keywords: acute kidney injury, acute interstitial nephritis, proteinuria, COVID-19 vaccineMira FSCosta Carvalho JAlmeida PAPimenta ACAlen Coutinho IFigueiredo CRodrigues LSousa VFerreira EPinto HEscada LGalvão AAlves RDove Medical Pressarticleacute kidney injuryacute interstitial nephritisproteinuriacovid-19 vaccineDiseases of the genitourinary system. UrologyRC870-923ENInternational Journal of Nephrology and Renovascular Disease, Vol Volume 14, Pp 421-426 (2021)
institution DOAJ
collection DOAJ
language EN
topic acute kidney injury
acute interstitial nephritis
proteinuria
covid-19 vaccine
Diseases of the genitourinary system. Urology
RC870-923
spellingShingle acute kidney injury
acute interstitial nephritis
proteinuria
covid-19 vaccine
Diseases of the genitourinary system. Urology
RC870-923
Mira FS
Costa Carvalho J
Almeida PA
Pimenta AC
Alen Coutinho I
Figueiredo C
Rodrigues L
Sousa V
Ferreira E
Pinto H
Escada L
Galvão A
Alves R
A Case of Acute Interstitial Nephritis After Two Doses of the BNT162b2 SARS-CoV-2 Vaccine
description Filipe S Mira,1,2,* Jóni Costa Carvalho,3,* Patrícia Amaral de Almeida,4 Ana Carolina Pimenta,1 Iolanda Alen Coutinho,3 Carolina Figueiredo,1 Luís Rodrigues,1,2 Vítor Sousa,2,5 Emanuel Ferreira,1,2 Helena Pinto,1,2 Luís Escada,1,2 Ana Galvão,1,2 Rui Alves1,2 1Nephrology Department, Coimbra University Hospital, Coimbra, Portugal; 2Coimbra University Faculty of Medicine, Coimbra, Portugal; 3Allergy and Clinical Immunology Department, Coimbra University Hospital, Coimbra, Portugal; 4Internal Medicine Department, Figueira da Foz Hospital, Figueira da Foz, Portugal; 5Pathological Anatomy Department, Coimbra University Hospital, Coimbra, Portugal*These authors contributed equally to this workCorrespondence: Filipe S Mira Rua Alfredo Lopes Xisto, nº 36, Coimbra, 3000-020, PortugalTel +351 932463036Email filipemira@netcabo.ptBackground: The development of vaccines to prevent COVID-19 breakouts came with highly positive results but some unexpected side effects. Rare side effects have been seen with the BNT162b2 SARS-CoV 2 vaccine.Case Presentation: We present the case of a 45-year-old female patient who developed an acute kidney injury needing urgent hemodialysis one week after the second administration of the BNT162b2 SARS-CoV 2 vaccine. She developed a macular rash on her lower limbs and palms as well. A kidney biopsy was performed 10 days after vaccine inoculation, diagnosing acute interstitial nephritis and acute tubular necrosis with cellular casts. The patient was treated with three corticosteroid pulses followed by daily prednisolone. We witnessed clinical improvement 4 days after the initial corticosteroid treatment with progressive recovery of kidney function and hemodialysis withdrawal. After 2 weeks, the patient had recovered her kidney function. Immunophenotyping was performed, diagnosing a hypersensitivity to the vaccine and the polyethylene glycol excipient.Conclusion: Patients may develop acute reactions to vaccines. In this case, symptoms seem to correlate significantly with its inoculation and, although this case had a favourable outcome, these side effects must be made aware for clinicians and patients.Keywords: acute kidney injury, acute interstitial nephritis, proteinuria, COVID-19 vaccine
format article
author Mira FS
Costa Carvalho J
Almeida PA
Pimenta AC
Alen Coutinho I
Figueiredo C
Rodrigues L
Sousa V
Ferreira E
Pinto H
Escada L
Galvão A
Alves R
author_facet Mira FS
Costa Carvalho J
Almeida PA
Pimenta AC
Alen Coutinho I
Figueiredo C
Rodrigues L
Sousa V
Ferreira E
Pinto H
Escada L
Galvão A
Alves R
author_sort Mira FS
title A Case of Acute Interstitial Nephritis After Two Doses of the BNT162b2 SARS-CoV-2 Vaccine
title_short A Case of Acute Interstitial Nephritis After Two Doses of the BNT162b2 SARS-CoV-2 Vaccine
title_full A Case of Acute Interstitial Nephritis After Two Doses of the BNT162b2 SARS-CoV-2 Vaccine
title_fullStr A Case of Acute Interstitial Nephritis After Two Doses of the BNT162b2 SARS-CoV-2 Vaccine
title_full_unstemmed A Case of Acute Interstitial Nephritis After Two Doses of the BNT162b2 SARS-CoV-2 Vaccine
title_sort case of acute interstitial nephritis after two doses of the bnt162b2 sars-cov-2 vaccine
publisher Dove Medical Press
publishDate 2021
url https://doaj.org/article/65f4e2c8601a4041b21cef91d526169b
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