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Abstract: FR-PO622

Renal Limited ANCA-Associated Vasculitis Associated With Cardiac Tamponade Following Pfizer-BioNTech SARS-CoV-2 Vaccination

Session Information

Category: Glomerular Diseases

  • 1302 Glomerular Diseases: Immunology and Inflammation

Authors

  • Mahmoud, Yasmin N., SUNY Downstate Health Sciences University, New York City, New York, United States
  • Elhawary, Omar Nabil, SUNY Downstate Health Sciences University, New York City, New York, United States
  • Mallappallil, Mary C., SUNY Downstate Health Sciences University, New York City, New York, United States
  • Agarwal, Sonalika, SUNY Downstate Health Sciences University, New York City, New York, United States
  • Puri, Isha, SUNY Downstate Health Sciences University, New York City, New York, United States
Introduction

While short-term side effects of COVID-19 vaccine resemble those of other vaccines, long-term side effects remain unknown. We report a case of new-onset renal-limited ANCA-associated vasculitis in an elderly woman who developed acute kidney injury with nephrotic range proteinuria after receiving the Pfizer-BioNTech COVID-19 vaccine.

Case Description

74- year-old woman with history of Hypertension, Diabetes presented with generalized fatigue and occasional cough after getting Pfizer-BioNTech covid vaccine in June 2021. She had nephrotic range proteinuria with UPCR of 4 g/g, serum positive for MPO-ANCA antibody with a titer of 1:160. CT chest showed moderate to large pericardial effusion which was subsequently confirmed on Echocardiogram. Kidney biopsy was done and showed MPO-ANCA mediated crescentic focal necrotizing and focal sclerosing glomerulonephritis. The patient later developed transient episode of SVT which required higher level of care and a pericardiocentesis was done for cardiac tamponade and impending cardiac collapse.

Discussion

Six cases of ANCA–associated glomerulonephritis after SARS-CoV-2 vaccination have been reported to date. We report a case of ANCA-associated vasculitis associated with cardiac tamponade following Pfizer-BioNTech SARS-CoV-2 vaccination. Since April 2021, increased cases of myocarditis and pericarditis have been reported in the United States after mRNA COVID-19 vaccination and reported cases have occurred predominantly in male adolescents and young adults 16 years of age and older. To our knowledge this is the first case of renal limited MPO-ANCA–associated vasculitis following Pfizer-BioNTech covid vaccine with association of cardiac tamponade in an elderly female. Diagnosis is often challenging, and post-marketing surveillance systems must continue to assess vaccine safety.

Crescents and Necrosis