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Abstract: PO1677

Nephrotic Syndrome Secondary to Minimal Change Disease Following Moderna COVID-19 Vaccine

Session Information

Category: Glomerular Diseases

  • 1204 Podocyte Biology

Authors

  • Thappy, Shaefiq Babu, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
  • Thalappil, Sherin Rahim, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
  • Abbarh, Shahem, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
  • Akhtar, Mohammed, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
  • Alkadi, Mohamad M., Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
Introduction

Minimal Change Disease (MCD) has been reported following vaccines against hepatitis, pneumococcus, influenza and measles. In the COVID-19 era, 3 cases of new-onset MCD and one case of MCD relapse have been reported following the Pfizer-BioNTech COVID-19 vaccine . We herein report a case of MCD after receiving the first dose of Moderna COVID-19 vaccine.

Case Description

A 43-year-old Ethiopian man with no significant past medical history presented with progressive bilateral lower limb edema for two weeks. His symptoms started 7 days after receiving the first dose of COVID-19 vaccine. He then developed dyspnea and scrotal swelling over the following 10-14 days. On physical examination, his blood pressure was 150/92 mm Hg. There was decreased air entry at lung bases, significant bilateral lower limb pitting edema extending to above the knees and scrotal swelling. Lab investigations revelaed hypoalbuminemia, hyperlipidemia and proteinuria of 15 grams. There was no hematuria and his immunologic and serologic work up was negative. Renal biopsy showed minimal change disease with underlying IgA nephropathy. There was no global or segmental glomerulosclerosis, mesangial or endocapillary proliferation. Patient was started on oral prednisolone and furosemide. His edema resolved, serum albumin doubled and proteinuria decreased within the first week of treatment.

Discussion

Symptoms of MCD have been reported 4 days to 16 weeks after vaccination. Although the pathogenesis of MCD is not fully understood, studies suggest that T-cell dysfunction might play a role. More studies are needed to determine the incidence and pathophysiology of this adverse event post COVID-19 vaccine. It is not clear in this case if or when the second dose of the COVID-19 vaccine should be administered.