J Korean Med Sci.  2022 Jul;37(26):e204. 10.3346/jkms.2022.37.e204.

A Case Report of MPO-ANCAAssociated Vasculitis Following Heterologous mRNA1273 COVID-19 Booster Vaccination

Affiliations
  • 1Division of Nephrology, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
  • 2Department of Pathology, Inje University Ilsan Paik Hospital, Goyang, Korea

Abstract

Despite that clinical trials have been examining the safety profile of coronavirus disease 2019 (COVID-19) vaccines, there are concerns about long-term side effects as the number of vaccinations increases. Herein, we report a case of new-onset renal-limited antimyeloperoxidase (MPO) antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis after booster vaccination with the mRNA 1273 (Moderna) vaccine. A 72-year-old woman with no specific past history, and who had a normal renal function, developed ANCAassociated vasculitis following heterologous booster with mRNA1273 (Moderna) vaccine. After a kidney biopsy, she was diagnosed with ANCA-associated pauci-immune crescentic glomerulonephritis. Her renal function and constitutional symptoms have been improved with treatment with plasmapheresis, intravenous cyclophosphamide and steroid pulse therapy (intravenous 500 mg of methylprednisolone sodium succinate for 3 days) followed by a reduced steroid regimen.

Keyword

ANCA-Vasculitis; Heterologous; mRNA1273 COVID-19 Vaccine

Figure

  • Fig. 1 Kidney biopsy showing (A) cellular crescent (white arrow) noted in a glomerulus. Inflammatory cell infiltration and fibrin deposit are also found. Tubules reveal protein and cellular casts in lumina (PAS stain ×200). (B) Ultrastructural examination shows diffuse effacement of foot processes (black arrow) with distorted and fused cytoplasms of podocytes (TEM ×2,000). Scale bar = 10 µm.


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Yu-Kyoung Hwang, Hui-Hwan Kwak, Jeong-Eun Yun, Sae-Hoon Kim, Yoon-Seok Chang
J Korean Med Sci. 2023;38(48):e382.    doi: 10.3346/jkms.2023.38.e382.


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