scholarly journals Minimal change disease following the Moderna COVID-19 vaccine: first case report

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Shaefiq Thappy ◽  
Sherin R. Thalappil ◽  
Shahem Abbarh ◽  
Abdulrahman Al-Mashdali ◽  
Mohammed Akhtar ◽  
...  
Keyword(s):  
Minimal Change Disease ◽  
Lower Extremities ◽  
Sudden Onset ◽  
Minimal Change ◽  
Glomerular Injury ◽  
First Case ◽  
Oral Steroids ◽  
Scrotal Edema ◽  
Scrotal Swelling ◽  
Work Up

Abstract Background There have been cases of minimal change disease (MCD) reported following previous vaccines. During the COVID-19 era, only 3 cases of new-onset MCD and a case of MCD relapse were reported following the Pfizer-BioNTech COVID-19 vaccine. We herein report the first case of MCD after receiving the Moderna COVID-19 vaccine. Case presentation A 43-year-old man presented to hospital 3 weeks after receiving the first dose of the Moderna vaccine, with both bilateral lower extremities and scrotal edema. He initially developed a sudden-onset bilateral lower extremities swelling on day 7 post-vaccine. He, then, developed dyspnea and scrotal swelling over a time span of 2 weeks. On physical examination, his blood pressure was 150/92 mmHg. There was a decreased air entry at lung bases, bilateral lower extremities and scrotal edema. Labs revealed hypoalbuminemia, hyperlipidemia and 15 g of proteinuria. His immunologic and serologic work up was negative. Renal biopsy showed concomitant MCD and IgA nephropathy. Patient was treated with oral steroids and had a good response; his edema resolved, serum albumin improved, and proteinuria decreased to 1 g within 2 weeks of treatment. Conclusions To the best of our knowledge, MCD has not been previously reported after receiving the Moderna COVID-19 vaccine. It remains unclear whether the COVID-19 mRNA vaccines are associated with the development of MCD, or it coincided with the mass vaccination. Further studies are needed to determine the incidence of MCD post COVID-19 vaccines and the underlying pathophysiology of glomerular injury post vaccination.

scholarly journals What about NSAID and secondary minimal change disease in adult’s people? A case report and review of the literature

2021 ◽  
Vol 7 (1) ◽  
pp. e12-e12
Author(s):  
Erica E Faure ◽  
Jorge H. Mukdsi
Keyword(s):  
Nephrotic Syndrome ◽  
Minimal Change Disease ◽  
Clinical Presentation ◽  
The Elderly ◽  
Minimal Change ◽  
Glomerular Injury ◽  
Drug Induced ◽  
History Of ◽  
Histological Characteristics ◽  
Inflammatory Drugs

Non-steroidal anti-inflammatory drugs (NSAIDs) have been used in the management of inflammatory disease for decades. The spectrum of nephrotoxicity attributed to NSAIDs includes mainly acute tubulointerstitial nephritis. However, much less attention has been given to drug-induced glomerular injury. NSAIDs treating patients presenting with nephrotic syndrome may have a variety of glomerular changes indistinguishable from those found in idiopathic minimal change disease (MCD), for example. The clinical presentation is typically abrupt with nephrotic syndrome while in the elderly it can present as acute renal failure from the beginning. We present an MCD-NSAID induced in elderly patient and discuss possible pathogenic mechanism, thinking about on the indiscriminate use of NSAIDs. Here we report the case of a 66-year-old woman with a history of nephrotic syndrome and hypertension without an apparent secondary etiology. However, an exhaustive history showed and indiscriminate use of NSAIDs. Renal biopsy showed a MCD with a mild interstitial nephritis. To our knowledge the morphology of drug-induced diseases often does not differ from the primary forms, making the distinction difficult. There are subtle clues, although the dialogue between clinician and pathologist is essential to reach an etiological diagnosis. Physicians should suspect glomerulonephritis in patients who receive drugs and its management must be determined based on the histological characteristics of the disease. Although corticosteroid therapy seems to be of value, the effectiveness of this approach must still be tested in randomized and multicentric clinical trials.

scholarly journals Minimal change disease associated with type 1 and type 2 diabetes mellitus

2012 ◽  
Vol 56 (5) ◽  
pp. 331-335 ◽  
Author(s):  
Miguel Moyses Neto ◽  
Gyl Eanes Barros Silva ◽  
Roberto S. Costa ◽  
Elen A. Romão ◽  
Osvaldo Merege Vieira Neto ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Type 1 Diabetes ◽  
Complete Remission ◽  
Minimal Change Disease ◽  
Immunosuppressive Agents ◽  
Sudden Onset ◽  
Minimal Change ◽  
Diabetic Patients

A 19-year-old female with type 1 diabetes for four years, and a 73-year-old female with type 2 diabetes for twenty years developed sudden-onset nephrotic syndrome. Examination by light microscopy, immunofluorescence, and electron microscopy (in one case) identified minimal change disease (MCD) in both cases. There was a potential causative drug (meloxicam) for the 73-year-old patient. Both patients were treated with prednisone and responded with complete remission. The patient with type 1 diabetes showed complete remission without relapse, and the patient with type 2 diabetes had two relapses; complete remission was sustained after associated treatment with cyclophosphamide and prednisone. Both patients had two years of follow-up evaluation after remission. We discuss the outcomes of both patients and emphasize the role of kidney biopsy in diabetic patients with an atypical proteinuric clinical course, because patients with MCD clearly respond to corticotherapy alone or in conjunction with other immunosuppressive agents.

A case of relapsing immunoglobulin A nephropathy secondary to immunotherapy

2020 ◽  
Vol 4 (3) ◽  
pp. 87-91
Author(s):  
Omar Mamlouk ◽  
Biruh Workeneh
Keyword(s):  
Minimal Change Disease ◽  
Checkpoint Inhibitor ◽  
Checkpoint Inhibitors ◽  
Immunoglobulin A ◽  
Kidney Injury ◽  
Acute Interstitial Nephritis ◽  
Minimal Change ◽  
Immunoglobulin A Nephropathy ◽  
First Case ◽  
Immunosuppression Therapy

An estimated 3% of patients treated with immune checkpoint inhibitors develop acute kidney injury during the treatment course. The majority of biopsy-proven checkpoint inhibitor–associated nephropathy is related to acute interstitial nephritis, but various glomerulonephritides have been reported, including immunoglobulin A nephropathy and minimal change disease. Secondary immunoglobulin A nephropathy can be associated with autoimmune and infectious disease, but, unlike minimal change disease, rarely as a result of medications. To date, there are no clear evidences that treating secondary immunoglobulin A nephropathy or minimal change disease with immunosuppression therapy provides resolution for glomerulonephritis. We report the first case of remission of checkpoint inhibitor–induced overlap immunoglobulin A/minimal change disease nephropathy treated with repository corticotrophin therapy.

Hodgkin Disease and Nephrotic Syndrome, a Rare Paraneoplastic Complication in Children with Literature Review

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4832-4832
Author(s):  
Sehba Dsilva ◽  
Gungor Karayalcin ◽  
Sharon Singh
Keyword(s):  
Nephrotic Syndrome ◽  
Renal Biopsy ◽  
Minimal Change Disease ◽  
Pediatric Population ◽  
Minimal Change ◽  
Hodgkin Disease ◽  
Humoral Factors ◽  
History Of ◽  
Work Up ◽  
Nodular Sclerosing

Abstract The association between Hodgkin Disease (HD) and paraneoplastic Nephrotic Syndrome is well documented in adults but is relatively uncommon in the pediatric population. We describe two children with HD who initially presented with Nephrotic Syndrome. Case 1: 12- year-old boy who presented with a two-week history of periorbital edema, proteinuria and hypertension and was diagnosed with Nephrotic Syndrome. The renal biopsy showed minimal change disease. Since the patient developed dyspnea, further work-up was done and he was found to have a large mediastinal mass. Core needle biopsy of the mass was consistent with HD, nodular sclerosing type. Case 2: 14-year-old boy diagnosed to have Nephrotic Syndrome with biopsy proven minimal change disease and was treated intermittently with steroids over 6 months. He subsequently developed dyspnea and was found to have a right paratracheal mass and excisinal biopsy was consistent with HD, nodular sclerosing type. Both these patients initially presented with Nephrotic Syndrome which completely resolved after the first course of chemotherapy for HD. Upon review of literature, there have been 23 pediatric cases of Nephrotic Syndrome associated with HD in patients ranging in age between 2–15 years. The renal biopsy was not done for 8 of these patients and the diagnosis was established clinically. Fifteen patients had biopsies, 9 had minimal change disease, 1 mesangial hypercellularity, 1 glomerulosclerosis, 1 undetermined histology and 3 were normal. In all cases, the Nephrotic Syndrome was refractory to steroids and resolved with treatment of the HD. Pathogenesis of the Nephrotic Syndrome associated with HD is not known, however there are speculations about T-cell involvement and production of lymphokines and humoral factors which may be responsible for the glomerular damage.

scholarly journals Acute ICA occlusion due to pituitary apoplexy resulting In Internal Carotid Artery Occlusion and Stroke: Case Report, Review of The Literature, and Treatment Rationale

2017 ◽  
Vol 1 (1) ◽  
pp. 01-03
Author(s):  
Ramu Adepu
Keyword(s):  
Tumor Resection ◽  
Rare Event ◽  
Treatment Strategies ◽  
Pituitary Tumors ◽  
Artery Occlusion ◽  
Carotid Artery Occlusion ◽  
Sudden Onset ◽  
First Case ◽  
Work Up ◽  
Transsphenoidal Resection

We report the case of a 63 year-old man who presented with sudden-onset, severe headache. Work-up revealed a hemorrhagic pituitary macroadenoma. He then suffered sudden-onset aphasia and right hemiparesis. Further evaluation revealed left ICA occlusion. Emergent transsphenoidal resection of the tumor produced recanalization of the occluded ICA, but his neurological symptoms persisted. ICA occlusion following pituitary tumor apoplexy is a rare event that must be recognized early for optimal patient outcomes. We report the first case with demonstration of carotid recanalization after tumor resection, review the incidence of ICA occlusion due to pituitary tumors, describe the possible mechanisms, and recommend optimal treatment strategies.

Recurrence of Anti-semaphorin-3B Mediated Membranous Nephropathy after Kidney Transplantation

2022 ◽  
pp. ASN.2021101323
Author(s):  
Marc Fila ◽  
Hanna Debiec ◽  
Hélène Perrochia ◽  
Nabila Djouadi ◽  
Verpont Marie-Christine ◽  
...  
Keyword(s):  
Electron Microscopy ◽  
Autoimmune Disease ◽  
Western Blot ◽  
Membranous Nephropathy ◽  
Minimal Change Disease ◽  
Pediatric Patients ◽  
Early Recurrence ◽  
Minimal Change ◽  
First Case ◽  
Nephrotic Range Proteinuria

Background: Membranous nephropathy (MN) is rare in pediatric patients, although its diagnosis may be underestimated in children who are responsive to corticosteroid therapy prescribed for a suspicion of minimal change disease. It is most often associated with an autoimmune disease, predominantly lupus. We previously reported the occurrence of early onset membranous nephropathy associated with Semaphorin 3B in 9 children and 2 adults. Methods: Biopsies were performed on native kidney and at 1 and 5 months after transplantation. Semaphorin 3B antigen was detected in immune deposits by immunohistochemistry and confocal microscopy on paraffin-embedded biopsies. Anti-Semaphorin antibodies were detected by Western blot and analyzed sequentially. Results: We report the first case of early recurrence after transplantation in a 7-year old boy who presented with severe nephrotic syndrome and advanced kidney failure. There was no evidence of hereditary or associated autoimmune disease. Abundant, almost coalescent deposits were seen by electron microscopy and bright granular, subepithelial staining was observed for Semaphorin 3B antigen. Western blot analysis of serum revealed antiSemaphorin 3B antibodies. Recurrence of MN occurred 25 days after transplantation and manifested as nephrotic range proteinuria despite conventional immunosuppressive therapy. Kidney biopsies confirmed histological MN recurrence with colocalization of Semaphorin 3B antigen and IgG (1). The patient was treated with rituximab. Anti-Semaphorin 3B antibodies, which were detected at transplantation, were not detected 40 days after rituximab. Conclusion: This case provides evidence that anti-Semaphorin 3B antibodies are pathogenic and should be monitored in patients with membranous nephropathy.

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