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Journal Scan
Lupus Nephritis

Case Report: Lupus Nephritis Class V Relapse After COVID-19 Vaccination

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One week after receiving the first dose of the COVID-19 mRNA vaccine, a 42-year-old woman in full remission from lupus nephritis class V experienced an increase in proteinuria from 0.07g/d to 6g/d. Five weeks after the first dose, proteinuria increased to 8.4g/d, and the patient developed nephrotic syndrome with hyperlipoproteinemia and hypalbuminemia, according to a case report.

Renal biopsy showed Lupus nephritis class V and II.

Immunosuppressive therapy with mycophenolate mofetil (1g bid) and prednisolone (60mg qd) was started after spontaneous remission did not occur.

“Our case report is the first to describe a biopsy-proven relapse of Lupus nephritis Class V and II,” the authors concluded. “It adds yet another evidence that relapses immune-mediated disease might be induced by COVID-19 mRNA vaccine. While the mechanisms triggering these relapses are still elusive, a stringent post-vaccination surveillance for renal function, proteinuria and serologic markers for immune disease is essential in this vulnerable patient population.”

Reference
Tuschen K, Bräsen JH, Schmitz J, et al. Relapse of Class V Lupus Nephritis after Vaccination with COVID-19 mRNA Vaccine. Kidney Int. 2021;S0085-2538(21)00738-9. doi: 10.1016/j.kint.2021.07.019. Epub ahead of print. PMID: 34352310; PMCID: PMC8328524.

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