Crescentic Glomerulonephritis with Fibrinoid Vasculitis after Administration of Influenza Vaccine: A Case Report

Risa Hara; Eiko Hasegawa; Noriko Inoue; Akinari Sekine; Kiho Tanaka; Daisuke Ikuma; Hiroki Mizuno; Yuki Oba; Masayuki Yamanouchi; Tatsuya Suwabe; Naoki Sawa; Kei Kono; Keiichi Kinowaki; Kenichi Ohashi; Yoshifumi Ubara; Junichi Hoshino

doi:10.2169/internalmedicine.9410-22

This article has now been updated. Please use the final version.

Crescentic Glomerulonephritis with Fibrinoid Vasculitis after Administration of Influenza Vaccine: A Case Report

Risa Hara, Eiko Hasegawa, Noriko Inoue, Akinari Sekine, Kiho Tanaka, Daisuke Ikuma, Hiroki Mizuno, Yuki Oba, Masayuki Yamanouchi, Tatsuya Suwabe, Naoki Sawa, Kei Kono, Keiichi Kinowaki, Kenichi Ohashi, Yoshifumi Ubara, Junichi Hoshino

Author information

Risa Hara
Nephrology Center and Department of Rheumatology and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
Eiko Hasegawa
Nephrology Center and Department of Rheumatology and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
Noriko Inoue
Nephrology Center and Department of Rheumatology and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
Akinari Sekine
Nephrology Center and Department of Rheumatology and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
Kiho Tanaka
Nephrology Center and Department of Rheumatology and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
Daisuke Ikuma
Nephrology Center and Department of Rheumatology and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
Hiroki Mizuno
Nephrology Center and Department of Rheumatology and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
Yuki Oba
Nephrology Center and Department of Rheumatology and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
Masayuki Yamanouchi
Nephrology Center and Department of Rheumatology and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
Tatsuya Suwabe
Nephrology Center and Department of Rheumatology and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
Naoki Sawa
Nephrology Center and Department of Rheumatology and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
Department of Human Pathology, Tokyo Medical and Dental University, 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 and Dental University, Japan
Yoshifumi Ubara
Nephrology Center and Department of Rheumatology and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan
Junichi Hoshino
Nephrology Center and Department of Rheumatology and Okinaka Memorial Institute for Medical Research, Toranomon Hospital, Japan

Keywords: microscopic polyangiitis, influenza vaccine, ANCA-associated vasculitis

JOURNAL OPEN ACCESS Advance online publication

Article ID: 9410-22

DOI https://doi.org/10.2169/internalmedicine.9410-22

The final version of this article is now available: Vol. 62 (2023), No. 7 pp. 1077-1080

Details

Abstract

A 66-year-old man was admitted to our hospital because of a low-grade fever and arthralgia. The symptoms started on the third day after influenza vaccine administration and persisted for two months. Serum creatinine was 1.0 mg/dL; CRP, 16.1 mg/dL; and MPO-ANCA, 4,170 IU/mL. A kidney biopsy showed crescentic glomerulonephritis with fibrinoid necrosis of small arteries. Microscopic polyangiitis was diagnosed. After five months of steroid pulse therapy and rituximab administration, the patient entered remission. There have been very few reports of this condition after influenza vaccine administration.

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