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