Is Podocytopathy Associated with Gross Hematuria after COVID-19 Vaccination in Patients with Immunoglobulin A Nephropathy?

Atsuhiko Suenaga; Naoki Sawa; Yuki Oba; Daisuke Ikuma; Akinari Sekine; Masayuki Yamanouchi; Eiko Hasegawa; Hiroki Mizuno; Tatsuya Suwabe; Kei Kono; Keiichi Kinowaki; Kenichi Ohashi; Motoaki Miyazono; Yutaka Yamaguchi; Noriko Uesugi; Yoshifumi Ubara

doi:10.2169/internalmedicine.3247-23

Atsuhiko Suenaga, Naoki Sawa, Yuki Oba, Daisuke Ikuma, Akinari Sekine, Masayuki Yamanouchi, Eiko Hasegawa, Hiroki Mizuno, Tatsuya Suwabe, Kei Kono, Keiichi Kinowaki, Kenichi Ohashi, Motoaki Miyazono, Yutaka Yamaguchi, Noriko Uesugi, Yoshifumi Ubara

Author information

Atsuhiko Suenaga
Department of Nephrology and Rheumatology, Toranomon Hospital Kajigaya, Japan
Yamaguchi's Pathology Laboratory, Japan
Naoki Sawa
Department of Nephrology and Rheumatology, Toranomon Hospital Kajigaya, Japan
Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
Yuki Oba
Department of Nephrology and Rheumatology, Toranomon Hospital Kajigaya, Japan
Daisuke Ikuma
Department of Nephrology and Rheumatology, Toranomon Hospital Kajigaya, Japan
Akinari Sekine
Department of Nephrology and Rheumatology, Toranomon Hospital, Japan
Masayuki Yamanouchi
Department of Nephrology and Rheumatology, Toranomon Hospital Kajigaya, Japan
Eiko Hasegawa
Department of Nephrology and Rheumatology, Toranomon Hospital, Japan
Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
Hiroki Mizuno
Department of Nephrology and Rheumatology, Toranomon Hospital Kajigaya, Japan
Tatsuya Suwabe
Department of Nephrology and Rheumatology, Toranomon Hospital Kajigaya, Japan
Kei Kono
Department of Pathology, Toranomon Hospital, Japan
Keiichi Kinowaki
Department of Pathology, Toranomon Hospital, Japan
Kenichi Ohashi
Department of Pathology, Toranomon Hospital, Japan
Department of Human Pathology, Tokyo Medical Dental University, Japan
Motoaki Miyazono
Department of Nephrology, Saga University Internal Medicine, Japan
Yutaka Yamaguchi
Yamaguchi's Pathology Laboratory, Japan
Noriko Uesugi
Department of Pathology, Faculty of Medicine, Fukuoka University, Japan
Yoshifumi Ubara
Department of Nephrology and Rheumatology, Toranomon Hospital Kajigaya, Japan
Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan

Keywords: COVID-19 vaccination, IgA nephropathy, podocytopathy

JOURNAL OPEN ACCESS Advance online publication

Article ID: 3247-23

DOI https://doi.org/10.2169/internalmedicine.3247-23

Details

Abstract

We experienced three cases of a fever and subsequent severe, prolonged gross hematuria after COVID-19 vaccination. A kidney biopsy revealed immunoglobulin A (IgA) nephropathy, and electron microscopy showed two types of podocytopathy (podocyte damage): loss of foot processes from the glomerular basement membrane and foot process effacement. Mesangial interposition was also present in cases 1 and 3 but not in case 2. Podocytopathy is known to be a cause of proteinuria; however, the reactions to COVID-19 vaccination described here suggest that it may also be related to hematuria in IgA nephropathy.

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