Clinical and Experimental Vaccine Research

The Korean Vaccine Society (대한백신학회)
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Acute interstitial nephritis with acute kidney injury after COVID-19 vaccination: a case report

  • Jimin Lim (Division of Nephrology, Department of Internal Medicine, Keimyung University School of Medicine) ;
  • Jin Hyuk Paek (Division of Nephrology, Department of Internal Medicine, Keimyung University School of Medicine) ;
  • Hyeong Chan Shin (Department of Pathology, Keimyung University School of Medicine) ;
  • Woo Yeong Park (Division of Nephrology, Department of Internal Medicine, Keimyung University School of Medicine) ;
  • Kyubok Jin (Division of Nephrology, Department of Internal Medicine, Keimyung University School of Medicine) ;
  • Misun Choe (Department of Pathology, Keimyung University School of Medicine) ;
  • Seungyeup Han (Division of Nephrology, Department of Internal Medicine, Keimyung University School of Medicine) ;
  • Yaerim Kim (Division of Nephrology, Department of Internal Medicine, Keimyung University School of Medicine)
  • Received : 2023.10.16
  • Accepted : 2023.10.24
  • Published : 2024.01.31
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Abstract

In the context of the massive spread of coronavirus disease 2019 (COVID-19), the development of a COVID-19 vaccine is urgently needed. The Pfizer-BioNTech COVID-19 vaccine has been widely applied across global populations. Herein, we report a case of acute interstitial nephritis with acute kidney injury in a young healthy subject after administration of the COVID-19 vaccine. A 20-year-old man was admitted with abdominal discomfort and nausea. He had received the Pfizer-BioNTech COVID-19 vaccine 6 days before. At 9 days after vaccination, his kidney function was decreased, with serum creatinine levels of 1.8 mg/dL. Even with supportive care with hydration, his kidney function worsened, and he underwent a kidney biopsy. The pathology findings revealed diffuse interstitial infiltration of inflammatory cells, predominantly comprising lymphocytes, with preservation of the glomerulus. No abnormal findings were noted by immunofluorescence or electron microscopy. Based on a diagnosis of drug-related acute interstitial nephritis, we treated the patient with high-dose prednisolone. After administration of prednisolone, kidney function slowly improved. A close linkage between COVID-19 vaccination and acute interstitial nephritis should be considered in the clinic, despite the low incidence.

Keywords

Acknowledgement

We would like to respect and appreciation to all medical staff around the world who are making a dedicated sacrifice against COVID-19. This study was supported by grant from the Keimyung University Dongsan Hospital (KUDH to Yaerim Kim).

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