- A case of pathologically confirmed membranous glomerulonephritis after COVID-19 recombinant vaccination
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Seong Gyu Kim,Seong Cho,In hee Lee
2022 ; 2022(1):
- 논문분류 :
- 춘계학술대회 초록집
Case Study: We report a case of pathologically confirmed membranous glomerulonephritis after COVID-19 recombinant vaccination. A 54-year-old man visited the outpatient department of nephrology due to worsening of proteinuria after COVID-19 recombinant vaccination. He had hypertension as an underlying disease and was diagnosed 5 years ago. He was taking a combination of temisartan 40mg and amlodipine 5mg once a day for the treatment of hypertension. After the first inoculation of Astrazenaca's COVID-19 recombinant vaccine, the urine protein/creatinine ratio was 1.239 g/gCr. After the second inoculation, peripheral edema occurred and the urine protein/creatinine ratio increased to 5.703 g/gCr, so a referral was made to the nephrologist. There was no microscopic hematuria. The patient's Cr was 0.7 mg/dL, total protein/albumin 4.9/3.1 g/dL, and total cholesterol 261 mg/dL. Both hepatitis b virus surface antigen and hepatitis c virus antibody were negative. On physical examination, grade 3 of pitting edema was observed in the both pretibial region. There were no obvious symptoms or imaging evidence related to thrombosis. A renal biopsy was performed, and membranous glomerulonephritis was diagnosed. Anti-phospholipase A2 receptor antibody was negative. We started immunosuppressive therapy with Prednisolone 1mg/kg. After 3 months of immunosuppressive treatment, the urine protein/creatinine ratio decreased to 0.242 g/gCr. Therefore, the development of membranous glomerulonephritis following the COVID-19 recombinant vaccine might be relevant. Steroid-based immunosuppressive therapy may be helpful if the patient has symptomatic nephrotic-range proteinuria.