Table 2.
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Summary of published cases of IgAN following COVID-19 vaccination

No.AuthorsAge/sexCountry (race)Medical historyBaseline (hhematuria/proteinuria/SCr)VaccineTiming of symptom onsetSymptomsUrinalysisBlood testRenal biopsy (MEST-C)TreatmentsOutcomes
New cases
 1Niel1413/FLuxembourgNoneNAmRNA (Pfizer)< D1 after 1st doseGH, AKI, NRP, fever, asthenia, muscle painproteinuria: 3.9 g/lSCr: 3.57 mg/dlIgAN (M1E1S0T0)Hemodialysis + high-dose steroid

  • R.

  • SCr improved to normal level within D30, microhematuria and a slight proteinuria persisted.

 2Abdel-Qader1512/MJordanianNoneNormalmRNA (Pfizer)< D1 after 1st doseGH, AKI, NRP, HTN, fever, fatigueRBC: 1920/µl, proteinuria: 1.7 g/lSCr: 1.77 mg/dl (D2)IgANHigh-dose steroid

  • R.

  • Remission of GH, AKI, proteinuria within D7

 3Okada1617/FJapanAsymptomatic hematuriaMicroscopic hematuriamRNA (Pfizer)

  • D4 after

  • 1st dose

GH, SRPUPCR: 0.37 g/g

  • SCr: 0.58 mg/dl,

  • IgG: 10.171 g/L,

  • C3: 0.907 g/l

IgAN (M0E0S0T0)Conservative

  • CR.

  • Hematuria changed to microscopic within 1 week, and proteinuria resolved spontaneously with D10 after 2nd dose

 4Fujita1740/FJapanOccult bloodSCr: 0.76 mg/dlmRNA (Pfizer)

  • D9 after

  • 1st dose

  • GH, NRP,

  • fever, chills,

  • shivering, thrombocytopenia, pyuria

  • RBC: 100/HPF,

  • UPCR: 18.13 g/g,

  • WBC: 5–9/HPF

  • SCr: 0.86 mg/dl (D9), 1.23 mg/dl (D15),

  • albumin: >3 g/dl,

  • IgA: 155 mg/dl,

  • C3: 88 mg/dl

IgAN (M1E0S0T0C1)Conservative, plasma exchange, ABPC/SBT

  • CR.

  • Proteinuria spontaneously resolved within D15, GH changed to microscopic within D15, SCr improved to within normal level within later 2 months.

 5Yokote3536/FJapanMicroscopic hematuria, proteinuria, rheumatoid arthritisNAmRNA (Pfizer)

  • D11 after

  • 1st dose

GH, NS

  • UPCR: 15.6 g/g,

  • RBC: >100/HPF

  • SCr: 0.9 mg/dl,

  • ALB: 1.9 g/dl

DPGN, IgAN (M1E1S1T0C0)High-dose steroid + immunosuppressive

  • R.

  • UPCR improved to 2.9 g/g within 4 weeks. RBC and ALB were 30-49/HPF and 3.2 g/dl within 8 weeks, respectively.

 6Klomjit1844/M

  • USA

  • (White)

NASCr: 1.1 mg/dlmRNA (Moderna)

  • D14 after

  • 1st dose

AKI, NRP

  • RBC: 21–30/HPF,

  • UTP: 14 g/d

SCr: 2.5 mg/dlIgAN, AINHigh-dose steroid

  • NR.

  • SCr, RBC and UTP were 3.6 mg/dl, 3-10/HPF and 5.6 g/d within 3 months, respectively.

 7Klomjit1866/M

  • USA

  • (White)

NASCr: 1.1 mg/dlmRNA (Moderna)

  • D14 after

  • 1st dose

  • GH, SNP,

  • pericarditis

  • RBC: 51–100/HPF,

  • UTP: 1.2 g/d

  • SCr: 1.5 mg/dl,

  • 2.2 mg/dl (2nd dose)

IgANPrednisonea

  • R.

  • Scr, RBC and UTP were 1.4 mg/dl, 3–10/HPF and 0.3 g/d within 5 months, respectively.

 8Fenoglio1974/MItalyNANormalAdenovirus vector (AstraZeneca)

  • D42 after

  • 1st dose

RF, NSNANAIgANSteroid + hemodialysis

  • NA

  • Died after 2 months of follow-up to acute heart attack.

 9Fenoglio1979/MItalyNANormalAdenovirus vector (AstraZeneca)

  • D61 after

  • 1st dose

RF, NSNANAIgAN

  • Steroid +

  • immunosuppressive

NA
 10Anderegg2039/MSwitzerlandHTNNAmRNA (Moderna)

  • Immediate after 2nd dose

GH, AKI, SRP, flu-like symptoms, severe feverNumerous RBCAKIIgANHigh-dose steroid + immunosuppressive

  • R.

  • SCr was normalized and proteinuria significantly decreased, but microhematuria persisted within several weeks

 11Lo2128/FChinaMicroscopic hematuria

  • SCr: 0.66 mg/dl,

  • UPCR: 20

  • mg/mmol

mRNA (Pfizer)

  • 3 h after

  • 2nd dose

GH, SRP

  • UPCR: 320

  • mg/mmol

  • SCr: 0.81 mg/dl,

  • ANA: 1:640

IgAN (M1E0S0T0C0)Conservative

  • CR.

  • SCr improved to within normal level and hematuria subsided spontaneously in D5, UPCR fell to 34 mg/mmol and ANA became negative within 3 weeks

 12Yotoke3519/MJapanMicroscopic hematuriaNAmRNA (Pfizer)

  • 18h after

  • 2nd dose

GH

  • RBC: 50–99/HPF,

  • UPCR: 1.5 g/g

SCr: 0.97 mg/dlDPGN, IgAN (M1E1S1T0C1)RASi

  • R.

  • UPCR improved to <1 g/g within 12 weeks.

 13Hanna2217/M

  • USA

  • (White)

Foamy urineNAmRNA (Pfizer)< D1 after 2nd doseGH, AKI, SRP, HTN grade 1UPCR: 1.75 g/g (D9)

  • SCr: 1.78 mg/dl (D6),

  • ALB: 3.8 g/dl

IgAN (M1E1S1T1C1)High-dose steroid

  • R.

  • Hematuria self-resolved in D4 and SCr improved to 1.2 mg/dl at D22

 14Abramson2330/MUSA (European and American ancestry)NoneNAmRNA (Moderna)

  • D1 after

  • 2nd dose

  • SRP, fevers,

  • chills, headache, brown-colored urine

  • UPCR: 0.8 g/g,

  • RBC: >30/HPF,

  • WBC: 11–30/HPF

  • SCr: 1.02 mg/dl,

  • IgA: 444 mg/dl

IgAN (M1E0S1T0C0)RASi

  • R.

  • GH changed to microscopic within D2, UPCR improved to 0.43 g/g within 6 weeks

 15Tan2441/FChineseGDMNormalmRNA (Pfizer)

  • D1 after

  • 2nd dose

AKI, GH, SRP, HTN grade 1, headache, generalized myalgia

  • RBC: >200 μl,

  • UPCR: 2.03 g/g

  • SCr: 1.73 mg/dl,

  • IgG : 12.9 g/l,

  • C3:0.83 g/l,

  • ANA : 1:320

IgANHigh-dose steroid + immunosuppressiveNA.
 16Leong2526/MSingaporeSuspected IgAN

  • SCr: 0.85 mg/dl,

  • UPCR: 74 mg/mmol

mRNA (Pfizer)

  • D1 after

  • 2nd dose

GH, AKI, SRP, feverUPCR: 174 mg/mmol, RBC: >100/HPF

  • SCr: 1.62 mg/dl,

  • ALB: 4 g/dl

IgANRASiNA
 17Park2650/MUSA

  • HTN, CKD,

  • mild proteinuria

  • SCr: 1.17 mg/dl,

  • RBC: 11–25/HPF,

  • UPCR: 2.4 g/g

mRNA (Moderna)

  • D1 after

  • 2nd dose

GH, AKI, NRP

  • RBC: >50/HPF,

  • UPRC: 3.56 g/g,

SCr: 1.54 mg/dlIgANRASi

  • R.

  • RBC, UPCR and SCr were 11–25/HPF, 2.2 g/g, 1.24 mg/dl following up 1 month, respectively.

 18Lim2742/FKoreaNoneNAmRNA (Moderna)

  • D1 after

  • 2nd dose

GHUTP :1.7 g/dSCr: 0.47 mg/dlIgAN (M0E1C1S1T0)RASi

  • PR.

  • GH disappeared within several days, but microhematuria and proteinuria persisted.

 19Uchiyama3615/MJapanMicroscopic hematuriaNAmRNA (Pfizer)

  • D1 after

  • 2nd dose

GH, fever, myalgia

  • UPCR: 0.9 g/g,

  • numerous RBC

SCr: 0.97 mg/dlIgAN (M1E0S0T0C1)Conservative

  • R.

  • GH spontaneously resolved within D6. Microhematuria and proteinuria persisted.

 20Uchiyama3618/MJapanMicroscopic hematuriaNAmRNA (Pfizer)

  • D2 after

  • 2nd dose

GH, fever, general malaise

  • UPCR: 0.4 g/g

  • numerous RBC

SCr: 0.82 mg/dlIgAN (M1E0S0T0C0)Conservative

  • R.

  • GH spontaneously resolved within D7. Microhematuria and proteinuria disappeared gradually.

 21Kudose2850/F

  • USA

  • (White)

  • HTN, APS,

  • obesity

  • SCr: 1.3 mg/dl,

  • RBC: 10–20/HPF,

  • UPCR: 1.3 g/g

mRNA (Moderna)

  • D2 after

  • 2nd dose

GH, AKI, SRP, fever, body aches

  • UPCR: 2 g/g,

  • RBC: >50/HPF

SCr: 1.7 mg/dlIgAN (M1E0S1T1C1)Conservative

  • R.

  • Hematuria resolved within D5.

 22Kudose2819/M

  • USA

  • (White)

Microscopic hematuriaNormalmRNA (Moderna)

  • D2 after

  • 2nd dose

GHnumerous RBCSCr: 1.2 mg/dlIgAN (M1E1S1T0C0)Conservative

  • R.

  • Hematuria resolved within D2.

 23Horino2917/MJapanMicroscopic hematuriaNAmRNA (Pfizer)

  • D2 after

  • 2nd dose

  • GH, SRP,

  • fever, headache,

  • UPCR: 1.0 g/g,

  • RBC: >100/HPF

  • SCr: 0.70 mg/dl,

  • CRP: 2.41 mg/dl

IgAN

  • Tonsillectomy +

  • high-dose steroid

  • PR.

  • Proteinuria and microhematuria persisted within 2 months later

 24Srinivasan3035/MUSA (Caucasian)Nephrolithiasis, ulcerative colitisSCr: 1 mg/dlmRNA (Moderna)

  • D2 after

  • 2nd dose

GH, AKI, SRPUPCR: 0.656 g/gSCr: 1.3 mg/dlIgAN (M1E1S0T0C1)Immunosuppressive

  • PR.

  • Hematuria resolved, SCr and UPCR returned to stable but not back to baseline within 4 weeks

 25Morisawa3116/MJapanAsymptomatic hematuria

  • SCr: 0.87 mg/dl,

  • RBC: 50–100/HPF,

  • UPCR: 0.03 g/g

mRNA (Pfizer)

  • D2 after

  • 2nd dose

GH, AKI, SRP, fever

  • UPCR:

  • 0.28 g/g (D6),

  • 0.35 g/g (D21)

  • SCr: 1.1 mg/dl (D6), 1.26 mg/dl (D20),

  • 1.29 mg/dl (D55)

IgAN (M0E1S0T0C1)

  • Steroid +

  • immunosuppressive

  • R

  • Remission of GH after D3, AKI after 3 months

 26Morisawa3113/FJapanAsymptomatic hematuria

  • SCr: 0.51 mg/dl,

  • RBC: 10–20/HPF,

  • UPCR: 0.08 g/g

mRNA (Pfizer)

  • D2 after

  • 2nd dose

GH, SRP, fever

  • UPCR: 1.99 g/g

  • (D7)

SCr: 0.54 mg/dlIgAN (M0E0S0T0C0)Conservation

  • R

  • Resolved of UPCR in 26 days.

 27Nihei3228/FJapanGH and mild proteinuria in 17 years oldNAmRNA (Pfizer)

  • D7 after

  • 2nd dose

GH

  • RBC: >100/HPF,

  • UPCR: 0.13 g/g,

  • Gd-IgA1: 23

  • ng/ml

  • C3: 85 U/L,

  • IgA: 283 mg/dl,

  • SCr: 0.7 mg/dl,

  • Gd-IgA1: 4 µg/ml

IgAN (M0S0E1T0C0)Conservative

  • CR

  • Proteinuria and hematuria resolved in 28 days.

 28Klomjit1838/M

  • USA

  • (White)

NASCr: 1.3 mg/dlmRNA (Pfizer)

  • D14 after

  • 2nd dose

GH, SRPRBC : 51–100/HPF UTP: 0.32 g/dSCr: 1.6 mg/dlIgANConservativeNA
 29Alonso3430/MSpain

  • Membranous proliferative glomerulonephritis type 1, CKD,

  • KT (2019)

  • SCr: 1.1 mg/dl,

  • UACR: 0.45 g/g

mRNA (Pfizer)

  • D34 after

  • 2nd dose

Microscopic hematuria

  • UACR: 0.4 g/g,

  • hematuria: 150/µl

  • SCr: 1.65 mg/dl,

  • 2.4 mg/dl (D50)

IgANSteroid

  • NR.

  • Hematuria, UACR and SCr were 30/µl, 0.47 g/g and 1.9 mg/dl within after 2 months, respectively.

 30Mokos3373/MCroatiaAAN, HTN, KTUTP: 0.25 g/dAdenovirus vector (AstraZeneca)

  • D35 after

  • 2nd dose

SRP, edema of the lower legs

  • UTP: 1.4 g/d,

  • RBC: 3–5/HPF

SCr: 1.67 mg/dlIgAN (M0E1S0T0C1)RASi

  • Progressed.

  • UTP and RBC were 1.9 g/d, 5–10/HP during the next 3 weeks, respectively.

 31Klomjit1862/M

  • USA

  • (White)

NASCr: 1.0 mg/dlmRNA (Pfizer)

  • D42 after

  • 2nd dose

AKI, SRP

  • RBC: 31–40/HPF,

  • UTP: 0.9 g/d

SCr: 2.2 mg/dlIgANConservative

  • R.

  • SCr, RBC and UTP were 2.0 mg/dl, <3/HPF and 0.2 g/d within 1.5 months, respectively

Relapsed cases
 1Perrin3741/FFrance

  • IgAN (2005),

  • KT (2013)

Microscopic hematuriamRNA (Pfizer)

  • D2 after

  • 1st dose

  • GH, SRP,

  • marked leukocytosis

  • UPCR: 0.47 g/g,

  • numerous RBC

  • SCr transiently

  • increased

IgANConservative

  • CR.

  • Symptoms spontaneously resolved.

 2Horino3846/FJapanIgAN, tonsillectomy

  • SCr was normal,

  • RBC: <5/HPF

mRNA (Pfizer)

  • 12h after

  • 2nd dose

  • GH, SRP,

  • fever, myalgia

  • proteinuria: 3+,

  • RBC: >100/HPF

SCr was normalIgANConservative

  • PR.

  • Proteinuria spontaneously resolved within 2 weeks, GH changed to microscopic within 2 weeks.

 3Negrea3938/F

  • USA

  • (White)

IgAN (2005)

  • UTP: 0.63 g/d,

  • Microscopic hematuria

mRNA (Moderna)8–24 h after 2nd dose

  • GH, SRP,

  • fever, body

  • aches, chills,

  • headache, fatigue

UTP: 0.82 g/dSCr was normalIgANConservative

  • PR.

  • Hematuria spontaneously resolved in 3 d, proteinuria was 1.4 g/d within 3 weeks.

 4Negrea3938/F

  • USA

  • (White)

IgAN (2019)

  • UTP: 0.43 g/d,

  • Microscopic hematuria

mRNA (Moderna)

  • 8–24 h after 2nd

  • dose

  • GH, SRP,

  • fever, body

  • aches, chills,

  • headache, fatigue

UTP: 0.59 g/dSCr was normalIgANConservative

  • CR.

  • Hematuria spontaneously resolved in 3 d, proteinuria was 0.4 g/d within 3 weeks.

 5Valenzuela4536/FSpainIgAN (2020)

  • SCr: 0.9 mg/dl,

  • UTP: 0.7 g/d,

  • Microhematuria

mRNA (Moderna)Few hours after 2nd doseGH, AKI, fever, malaiseUTP: 1.5 g/d

  • SCr: 1.8 mg/dl,

  • IgA: 2174 mg/l

IgANHigh-dose steroid + immunosuppressive

  • R.

  • SCr and proteinuria were 1.09 mg/dl and 0.5 g/d after 2 months, respectively.

 6Rahim4052/FAsianIgAN (2017)ACR: <1 g/gmRAN (Pfizer)

  • < D1 after

  • 2nd dose

  • GH, SRP,

  • fever, generalized myalgias, lumbago bilaterally

  • numerous RBC,

  • ACR: 2.4 g/g

NAIgANConservative

  • CR.

  • Hematuria resolved within 1 week, ACR was 1.44 g/g within D5.

 7Plasse41NAUSAIgAN (2020)

  • SCr: 1.0 mg/dl,

  • UPCR: 0.61 mg/g

mRNA (Pfizer)< D1 after 2nd dose

  • GH, body

  • aches

  • UPCR: 0.92 mg/g,

  • numerous RBC

SCr: 1.16 mg/dlIgANConservative

  • CR.

  • Hematuria resolved within D3.

 8Hanna2213/M

  • USA

  • (White)

IgAN, T1DM

  • SCr: 0.54 mg/dl,

  • UPCR: 1.6 g/g,

  • ALB: 3.4 g/dl

mRNA (Pfizer)< D1 after 2nd doseGH, SRP, AKI, vomiting

  • UPCR: 1.07 g/g,

  • numerous RBC

SCr: 1.31 mg/dl (D2), ALB: 3.8 g/dl

  • IgAN

  • (M0E0S0T0C0)

Conservative

  • CR.

  • Hematuria and AKI resolved within D6, UPCR was 0.86 g/g (D6).

 9Srinivasan3025/FEuropeanIgAN

  • SCr: 0.7 mg/dl,

  • UPCR: 1.41 g/g

mRNA (Moderna)

  • D1 after

  • 2nd dose

GH, AKI, NRPUPCR: 4.76 g/gSCr: 1.07 mg/dlIgANConservative

  • CR.

  • Hematuria resolved, SCr and UPCR returned to baseline within 3 weeks.

 10Perrin3727/FFrance

  • IgAN (2020),

  • HD

NormalmRNA (Pfizer)

  • D2 after

  • 2nd dose

  • GH, SRP,

  • abdominal pain, urticaria at D5,

  • moderate pancytopenia,

  • UPCR: 1.9 g/g,

  • numerous RBC

NAIgANConservative

  • R.

  • Symptoms spontaneously resolved, UPCR was 1.2 g/g within 1 month after 2nd dose.

 11Watanabe4254/FUSA (Caucasian)

  • IgAN (2006),

  • obesity, HTN,

  • GERD

  • SCr: 1.2 mg/dl,

  • UPCR: 1.03 g/g,

  • RBC: 15/HPF

mRNA (Moderna)

  • D2 after

  • 2nd dose

GH, AKI, SRP

  • RBC: 50/HPF,

  • UPCR: 0.67 g/g

SCr: 3.04 mg/dl (D7)Active IgANSteroids

  • R.

  • Remission of GH after 2 days, AKI in 3 months.

 12Udagawa4315/FJapanIgANNAmRNA (Pfizer)

  • D2 after

  • 2nd dose

GH, SRP, fever

  • numerous RBC,

  • mild proteinuria

SCr was normalIgANConservation

  • R.

  • Remission of GH after 3 days.

 13Udagawa4316/FJapanIgANNormalmRNA (Pfizer)

  • D3 after

  • 2nd dose

  • GH, fever,

  • headache

numerous RBCSCr was normalIgANConservation

  • R.

  • Remission of GH after 2 days.

 14Plasse41NAUSAIgAN (2018)

  • SCr: 0.8 mg/dl,

  • UPCR: 1.56 mg/g

mRNA (Pfizer)

  • D5 after

  • 2nd dose

  • GH, AKI,

  • fevers, chills,

  • body aches,

  • dysuria

  • UPCR: 3.0 mg/g,

  • numerous RBC

SCr: 3.53 mg/dlIgANSteroids

  • R.

  • SCr and proteinuria

  • recovered baseline within 1 month and 2 months, respectively.

 15Klomjit1819/M

  • USA

  • (White)

IgANSCr: 0.96 mg/dlmRNA (Moderna)

  • D7 after

  • 2nd dose

GH, SRP

  • RBC: 50–100/HPF,

  • UTP: 0.61 g/d

SCr: 0.76 mg/dlIgANConservativeNA.
 16Yokote3548/FJapanIgAN (M0E1S1T0C1), tonsillectomyUTP: 0.91 g/dmRNA (Pfizer)

  • D14 after

  • 2nd dose

NS, GH

  • RBC: >100/HPF,

  • UPCR: 19.05 g/g

  • SCr: 0.94 mg/dl

  • ALB: 2.2 g/dl

DPGN, IgAN (M0E1S1T0C1)High-dose steroid

  • PR.

  • UPCR was 6 g/g within 4 weeks.

 17Schaubschlager4435/FUSAIgAN, psoriasis

  • SCr: 1.0 mg/dl,

  • UPCR: 0.36 g/g

mRNA (Pfizer)

  • D79 after

  • 2nd dose

SRPUPCR: 2 g/gSCr: 1.1 mg/dlIgAN (M1E1S1T0C1)High-dose steroid + immunosuppressive

  • R.

  • UPCR was 1.14 g/g within 4 weeks.

No.AuthorsAge/sexCountry (race)Medical historyBaseline (hhematuria/proteinuria/SCr)VaccineTiming of symptom onsetSymptomsUrinalysisBlood testRenal biopsy (MEST-C)TreatmentsOutcomes
New cases
 1Niel1413/FLuxembourgNoneNAmRNA (Pfizer)< D1 after 1st doseGH, AKI, NRP, fever, asthenia, muscle painproteinuria: 3.9 g/lSCr: 3.57 mg/dlIgAN (M1E1S0T0)Hemodialysis + high-dose steroid

  • R.

  • SCr improved to normal level within D30, microhematuria and a slight proteinuria persisted.

 2Abdel-Qader1512/MJordanianNoneNormalmRNA (Pfizer)< D1 after 1st doseGH, AKI, NRP, HTN, fever, fatigueRBC: 1920/µl, proteinuria: 1.7 g/lSCr: 1.77 mg/dl (D2)IgANHigh-dose steroid

  • R.

  • Remission of GH, AKI, proteinuria within D7

 3Okada1617/FJapanAsymptomatic hematuriaMicroscopic hematuriamRNA (Pfizer)

  • D4 after

  • 1st dose

GH, SRPUPCR: 0.37 g/g

  • SCr: 0.58 mg/dl,

  • IgG: 10.171 g/L,

  • C3: 0.907 g/l

IgAN (M0E0S0T0)Conservative

  • CR.

  • Hematuria changed to microscopic within 1 week, and proteinuria resolved spontaneously with D10 after 2nd dose

 4Fujita1740/FJapanOccult bloodSCr: 0.76 mg/dlmRNA (Pfizer)

  • D9 after

  • 1st dose

  • GH, NRP,

  • fever, chills,

  • shivering, thrombocytopenia, pyuria

  • RBC: 100/HPF,

  • UPCR: 18.13 g/g,

  • WBC: 5–9/HPF

  • SCr: 0.86 mg/dl (D9), 1.23 mg/dl (D15),

  • albumin: >3 g/dl,

  • IgA: 155 mg/dl,

  • C3: 88 mg/dl

IgAN (M1E0S0T0C1)Conservative, plasma exchange, ABPC/SBT

  • CR.

  • Proteinuria spontaneously resolved within D15, GH changed to microscopic within D15, SCr improved to within normal level within later 2 months.

 5Yokote3536/FJapanMicroscopic hematuria, proteinuria, rheumatoid arthritisNAmRNA (Pfizer)

  • D11 after

  • 1st dose

GH, NS

  • UPCR: 15.6 g/g,

  • RBC: >100/HPF

  • SCr: 0.9 mg/dl,

  • ALB: 1.9 g/dl

DPGN, IgAN (M1E1S1T0C0)High-dose steroid + immunosuppressive

  • R.

  • UPCR improved to 2.9 g/g within 4 weeks. RBC and ALB were 30-49/HPF and 3.2 g/dl within 8 weeks, respectively.

 6Klomjit1844/M

  • USA

  • (White)

NASCr: 1.1 mg/dlmRNA (Moderna)

  • D14 after

  • 1st dose

AKI, NRP

  • RBC: 21–30/HPF,

  • UTP: 14 g/d

SCr: 2.5 mg/dlIgAN, AINHigh-dose steroid

  • NR.

  • SCr, RBC and UTP were 3.6 mg/dl, 3-10/HPF and 5.6 g/d within 3 months, respectively.

 7Klomjit1866/M

  • USA

  • (White)

NASCr: 1.1 mg/dlmRNA (Moderna)

  • D14 after

  • 1st dose

  • GH, SNP,

  • pericarditis

  • RBC: 51–100/HPF,

  • UTP: 1.2 g/d

  • SCr: 1.5 mg/dl,

  • 2.2 mg/dl (2nd dose)

IgANPrednisonea

  • R.

  • Scr, RBC and UTP were 1.4 mg/dl, 3–10/HPF and 0.3 g/d within 5 months, respectively.

 8Fenoglio1974/MItalyNANormalAdenovirus vector (AstraZeneca)

  • D42 after

  • 1st dose

RF, NSNANAIgANSteroid + hemodialysis

  • NA

  • Died after 2 months of follow-up to acute heart attack.

 9Fenoglio1979/MItalyNANormalAdenovirus vector (AstraZeneca)

  • D61 after

  • 1st dose

RF, NSNANAIgAN

  • Steroid +

  • immunosuppressive

NA
 10Anderegg2039/MSwitzerlandHTNNAmRNA (Moderna)

  • Immediate after 2nd dose

GH, AKI, SRP, flu-like symptoms, severe feverNumerous RBCAKIIgANHigh-dose steroid + immunosuppressive

  • R.

  • SCr was normalized and proteinuria significantly decreased, but microhematuria persisted within several weeks

 11Lo2128/FChinaMicroscopic hematuria

  • SCr: 0.66 mg/dl,

  • UPCR: 20

  • mg/mmol

mRNA (Pfizer)

  • 3 h after

  • 2nd dose

GH, SRP

  • UPCR: 320

  • mg/mmol

  • SCr: 0.81 mg/dl,

  • ANA: 1:640

IgAN (M1E0S0T0C0)Conservative

  • CR.

  • SCr improved to within normal level and hematuria subsided spontaneously in D5, UPCR fell to 34 mg/mmol and ANA became negative within 3 weeks

 12Yotoke3519/MJapanMicroscopic hematuriaNAmRNA (Pfizer)

  • 18h after

  • 2nd dose

GH

  • RBC: 50–99/HPF,

  • UPCR: 1.5 g/g

SCr: 0.97 mg/dlDPGN, IgAN (M1E1S1T0C1)RASi

  • R.

  • UPCR improved to <1 g/g within 12 weeks.

 13Hanna2217/M

  • USA

  • (White)

Foamy urineNAmRNA (Pfizer)< D1 after 2nd doseGH, AKI, SRP, HTN grade 1UPCR: 1.75 g/g (D9)

  • SCr: 1.78 mg/dl (D6),

  • ALB: 3.8 g/dl

IgAN (M1E1S1T1C1)High-dose steroid

  • R.

  • Hematuria self-resolved in D4 and SCr improved to 1.2 mg/dl at D22

 14Abramson2330/MUSA (European and American ancestry)NoneNAmRNA (Moderna)

  • D1 after

  • 2nd dose

  • SRP, fevers,

  • chills, headache, brown-colored urine

  • UPCR: 0.8 g/g,

  • RBC: >30/HPF,

  • WBC: 11–30/HPF

  • SCr: 1.02 mg/dl,

  • IgA: 444 mg/dl

IgAN (M1E0S1T0C0)RASi

  • R.

  • GH changed to microscopic within D2, UPCR improved to 0.43 g/g within 6 weeks

 15Tan2441/FChineseGDMNormalmRNA (Pfizer)

  • D1 after

  • 2nd dose

AKI, GH, SRP, HTN grade 1, headache, generalized myalgia

  • RBC: >200 μl,

  • UPCR: 2.03 g/g

  • SCr: 1.73 mg/dl,

  • IgG : 12.9 g/l,

  • C3:0.83 g/l,

  • ANA : 1:320

IgANHigh-dose steroid + immunosuppressiveNA.
 16Leong2526/MSingaporeSuspected IgAN

  • SCr: 0.85 mg/dl,

  • UPCR: 74 mg/mmol

mRNA (Pfizer)

  • D1 after

  • 2nd dose

GH, AKI, SRP, feverUPCR: 174 mg/mmol, RBC: >100/HPF

  • SCr: 1.62 mg/dl,

  • ALB: 4 g/dl

IgANRASiNA
 17Park2650/MUSA

  • HTN, CKD,

  • mild proteinuria

  • SCr: 1.17 mg/dl,

  • RBC: 11–25/HPF,

  • UPCR: 2.4 g/g

mRNA (Moderna)

  • D1 after

  • 2nd dose

GH, AKI, NRP

  • RBC: >50/HPF,

  • UPRC: 3.56 g/g,

SCr: 1.54 mg/dlIgANRASi

  • R.

  • RBC, UPCR and SCr were 11–25/HPF, 2.2 g/g, 1.24 mg/dl following up 1 month, respectively.

 18Lim2742/FKoreaNoneNAmRNA (Moderna)

  • D1 after

  • 2nd dose

GHUTP :1.7 g/dSCr: 0.47 mg/dlIgAN (M0E1C1S1T0)RASi

  • PR.

  • GH disappeared within several days, but microhematuria and proteinuria persisted.

 19Uchiyama3615/MJapanMicroscopic hematuriaNAmRNA (Pfizer)

  • D1 after

  • 2nd dose

GH, fever, myalgia

  • UPCR: 0.9 g/g,

  • numerous RBC

SCr: 0.97 mg/dlIgAN (M1E0S0T0C1)Conservative

  • R.

  • GH spontaneously resolved within D6. Microhematuria and proteinuria persisted.

 20Uchiyama3618/MJapanMicroscopic hematuriaNAmRNA (Pfizer)

  • D2 after

  • 2nd dose

GH, fever, general malaise

  • UPCR: 0.4 g/g

  • numerous RBC

SCr: 0.82 mg/dlIgAN (M1E0S0T0C0)Conservative

  • R.

  • GH spontaneously resolved within D7. Microhematuria and proteinuria disappeared gradually.

 21Kudose2850/F

  • USA

  • (White)

  • HTN, APS,

  • obesity

  • SCr: 1.3 mg/dl,

  • RBC: 10–20/HPF,

  • UPCR: 1.3 g/g

mRNA (Moderna)

  • D2 after

  • 2nd dose

GH, AKI, SRP, fever, body aches

  • UPCR: 2 g/g,

  • RBC: >50/HPF

SCr: 1.7 mg/dlIgAN (M1E0S1T1C1)Conservative

  • R.

  • Hematuria resolved within D5.

 22Kudose2819/M

  • USA

  • (White)

Microscopic hematuriaNormalmRNA (Moderna)

  • D2 after

  • 2nd dose

GHnumerous RBCSCr: 1.2 mg/dlIgAN (M1E1S1T0C0)Conservative

  • R.

  • Hematuria resolved within D2.

 23Horino2917/MJapanMicroscopic hematuriaNAmRNA (Pfizer)

  • D2 after

  • 2nd dose

  • GH, SRP,

  • fever, headache,

  • UPCR: 1.0 g/g,

  • RBC: >100/HPF

  • SCr: 0.70 mg/dl,

  • CRP: 2.41 mg/dl

IgAN

  • Tonsillectomy +

  • high-dose steroid

  • PR.

  • Proteinuria and microhematuria persisted within 2 months later

 24Srinivasan3035/MUSA (Caucasian)Nephrolithiasis, ulcerative colitisSCr: 1 mg/dlmRNA (Moderna)

  • D2 after

  • 2nd dose

GH, AKI, SRPUPCR: 0.656 g/gSCr: 1.3 mg/dlIgAN (M1E1S0T0C1)Immunosuppressive

  • PR.

  • Hematuria resolved, SCr and UPCR returned to stable but not back to baseline within 4 weeks

 25Morisawa3116/MJapanAsymptomatic hematuria

  • SCr: 0.87 mg/dl,

  • RBC: 50–100/HPF,

  • UPCR: 0.03 g/g

mRNA (Pfizer)

  • D2 after

  • 2nd dose

GH, AKI, SRP, fever

  • UPCR:

  • 0.28 g/g (D6),

  • 0.35 g/g (D21)

  • SCr: 1.1 mg/dl (D6), 1.26 mg/dl (D20),

  • 1.29 mg/dl (D55)

IgAN (M0E1S0T0C1)

  • Steroid +

  • immunosuppressive

  • R

  • Remission of GH after D3, AKI after 3 months

 26Morisawa3113/FJapanAsymptomatic hematuria

  • SCr: 0.51 mg/dl,

  • RBC: 10–20/HPF,

  • UPCR: 0.08 g/g

mRNA (Pfizer)

  • D2 after

  • 2nd dose

GH, SRP, fever

  • UPCR: 1.99 g/g

  • (D7)

SCr: 0.54 mg/dlIgAN (M0E0S0T0C0)Conservation

  • R

  • Resolved of UPCR in 26 days.

 27Nihei3228/FJapanGH and mild proteinuria in 17 years oldNAmRNA (Pfizer)

  • D7 after

  • 2nd dose

GH

  • RBC: >100/HPF,

  • UPCR: 0.13 g/g,

  • Gd-IgA1: 23

  • ng/ml

  • C3: 85 U/L,

  • IgA: 283 mg/dl,

  • SCr: 0.7 mg/dl,

  • Gd-IgA1: 4 µg/ml

IgAN (M0S0E1T0C0)Conservative

  • CR

  • Proteinuria and hematuria resolved in 28 days.

 28Klomjit1838/M

  • USA

  • (White)

NASCr: 1.3 mg/dlmRNA (Pfizer)

  • D14 after

  • 2nd dose

GH, SRPRBC : 51–100/HPF UTP: 0.32 g/dSCr: 1.6 mg/dlIgANConservativeNA
 29Alonso3430/MSpain

  • Membranous proliferative glomerulonephritis type 1, CKD,

  • KT (2019)

  • SCr: 1.1 mg/dl,

  • UACR: 0.45 g/g

mRNA (Pfizer)

  • D34 after

  • 2nd dose

Microscopic hematuria

  • UACR: 0.4 g/g,

  • hematuria: 150/µl

  • SCr: 1.65 mg/dl,

  • 2.4 mg/dl (D50)

IgANSteroid

  • NR.

  • Hematuria, UACR and SCr were 30/µl, 0.47 g/g and 1.9 mg/dl within after 2 months, respectively.

 30Mokos3373/MCroatiaAAN, HTN, KTUTP: 0.25 g/dAdenovirus vector (AstraZeneca)

  • D35 after

  • 2nd dose

SRP, edema of the lower legs

  • UTP: 1.4 g/d,

  • RBC: 3–5/HPF

SCr: 1.67 mg/dlIgAN (M0E1S0T0C1)RASi

  • Progressed.

  • UTP and RBC were 1.9 g/d, 5–10/HP during the next 3 weeks, respectively.

 31Klomjit1862/M

  • USA

  • (White)

NASCr: 1.0 mg/dlmRNA (Pfizer)

  • D42 after

  • 2nd dose

AKI, SRP

  • RBC: 31–40/HPF,

  • UTP: 0.9 g/d

SCr: 2.2 mg/dlIgANConservative

  • R.

  • SCr, RBC and UTP were 2.0 mg/dl, <3/HPF and 0.2 g/d within 1.5 months, respectively

Relapsed cases
 1Perrin3741/FFrance

  • IgAN (2005),

  • KT (2013)

Microscopic hematuriamRNA (Pfizer)

  • D2 after

  • 1st dose

  • GH, SRP,

  • marked leukocytosis

  • UPCR: 0.47 g/g,

  • numerous RBC

  • SCr transiently

  • increased

IgANConservative

  • CR.

  • Symptoms spontaneously resolved.

 2Horino3846/FJapanIgAN, tonsillectomy

  • SCr was normal,

  • RBC: <5/HPF

mRNA (Pfizer)

  • 12h after

  • 2nd dose

  • GH, SRP,

  • fever, myalgia

  • proteinuria: 3+,

  • RBC: >100/HPF

SCr was normalIgANConservative

  • PR.

  • Proteinuria spontaneously resolved within 2 weeks, GH changed to microscopic within 2 weeks.

 3Negrea3938/F

  • USA

  • (White)

IgAN (2005)

  • UTP: 0.63 g/d,

  • Microscopic hematuria

mRNA (Moderna)8–24 h after 2nd dose

  • GH, SRP,

  • fever, body

  • aches, chills,

  • headache, fatigue

UTP: 0.82 g/dSCr was normalIgANConservative

  • PR.

  • Hematuria spontaneously resolved in 3 d, proteinuria was 1.4 g/d within 3 weeks.

 4Negrea3938/F

  • USA

  • (White)

IgAN (2019)

  • UTP: 0.43 g/d,

  • Microscopic hematuria

mRNA (Moderna)

  • 8–24 h after 2nd

  • dose

  • GH, SRP,

  • fever, body

  • aches, chills,

  • headache, fatigue

UTP: 0.59 g/dSCr was normalIgANConservative

  • CR.

  • Hematuria spontaneously resolved in 3 d, proteinuria was 0.4 g/d within 3 weeks.

 5Valenzuela4536/FSpainIgAN (2020)

  • SCr: 0.9 mg/dl,

  • UTP: 0.7 g/d,

  • Microhematuria

mRNA (Moderna)Few hours after 2nd doseGH, AKI, fever, malaiseUTP: 1.5 g/d

  • SCr: 1.8 mg/dl,

  • IgA: 2174 mg/l

IgANHigh-dose steroid + immunosuppressive

  • R.

  • SCr and proteinuria were 1.09 mg/dl and 0.5 g/d after 2 months, respectively.

 6Rahim4052/FAsianIgAN (2017)ACR: <1 g/gmRAN (Pfizer)

  • < D1 after

  • 2nd dose

  • GH, SRP,

  • fever, generalized myalgias, lumbago bilaterally

  • numerous RBC,

  • ACR: 2.4 g/g

NAIgANConservative

  • CR.

  • Hematuria resolved within 1 week, ACR was 1.44 g/g within D5.

 7Plasse41NAUSAIgAN (2020)

  • SCr: 1.0 mg/dl,

  • UPCR: 0.61 mg/g

mRNA (Pfizer)< D1 after 2nd dose

  • GH, body

  • aches

  • UPCR: 0.92 mg/g,

  • numerous RBC

SCr: 1.16 mg/dlIgANConservative

  • CR.

  • Hematuria resolved within D3.

 8Hanna2213/M

  • USA

  • (White)

IgAN, T1DM

  • SCr: 0.54 mg/dl,

  • UPCR: 1.6 g/g,

  • ALB: 3.4 g/dl

mRNA (Pfizer)< D1 after 2nd doseGH, SRP, AKI, vomiting

  • UPCR: 1.07 g/g,

  • numerous RBC

SCr: 1.31 mg/dl (D2), ALB: 3.8 g/dl

  • IgAN

  • (M0E0S0T0C0)

Conservative

  • CR.

  • Hematuria and AKI resolved within D6, UPCR was 0.86 g/g (D6).

 9Srinivasan3025/FEuropeanIgAN

  • SCr: 0.7 mg/dl,

  • UPCR: 1.41 g/g

mRNA (Moderna)

  • D1 after

  • 2nd dose

GH, AKI, NRPUPCR: 4.76 g/gSCr: 1.07 mg/dlIgANConservative

  • CR.

  • Hematuria resolved, SCr and UPCR returned to baseline within 3 weeks.

 10Perrin3727/FFrance

  • IgAN (2020),

  • HD

NormalmRNA (Pfizer)

  • D2 after

  • 2nd dose

  • GH, SRP,

  • abdominal pain, urticaria at D5,

  • moderate pancytopenia,

  • UPCR: 1.9 g/g,

  • numerous RBC

NAIgANConservative

  • R.

  • Symptoms spontaneously resolved, UPCR was 1.2 g/g within 1 month after 2nd dose.

 11Watanabe4254/FUSA (Caucasian)

  • IgAN (2006),

  • obesity, HTN,

  • GERD

  • SCr: 1.2 mg/dl,

  • UPCR: 1.03 g/g,

  • RBC: 15/HPF

mRNA (Moderna)

  • D2 after

  • 2nd dose

GH, AKI, SRP

  • RBC: 50/HPF,

  • UPCR: 0.67 g/g

SCr: 3.04 mg/dl (D7)Active IgANSteroids

  • R.

  • Remission of GH after 2 days, AKI in 3 months.

 12Udagawa4315/FJapanIgANNAmRNA (Pfizer)

  • D2 after

  • 2nd dose

GH, SRP, fever

  • numerous RBC,

  • mild proteinuria

SCr was normalIgANConservation

  • R.

  • Remission of GH after 3 days.

 13Udagawa4316/FJapanIgANNormalmRNA (Pfizer)

  • D3 after

  • 2nd dose

  • GH, fever,

  • headache

numerous RBCSCr was normalIgANConservation

  • R.

  • Remission of GH after 2 days.

 14Plasse41NAUSAIgAN (2018)

  • SCr: 0.8 mg/dl,

  • UPCR: 1.56 mg/g

mRNA (Pfizer)

  • D5 after

  • 2nd dose

  • GH, AKI,

  • fevers, chills,

  • body aches,

  • dysuria

  • UPCR: 3.0 mg/g,

  • numerous RBC

SCr: 3.53 mg/dlIgANSteroids

  • R.

  • SCr and proteinuria

  • recovered baseline within 1 month and 2 months, respectively.

 15Klomjit1819/M

  • USA

  • (White)

IgANSCr: 0.96 mg/dlmRNA (Moderna)

  • D7 after

  • 2nd dose

GH, SRP

  • RBC: 50–100/HPF,

  • UTP: 0.61 g/d

SCr: 0.76 mg/dlIgANConservativeNA.
 16Yokote3548/FJapanIgAN (M0E1S1T0C1), tonsillectomyUTP: 0.91 g/dmRNA (Pfizer)

  • D14 after

  • 2nd dose

NS, GH

  • RBC: >100/HPF,

  • UPCR: 19.05 g/g

  • SCr: 0.94 mg/dl

  • ALB: 2.2 g/dl

DPGN, IgAN (M0E1S1T0C1)High-dose steroid

  • PR.

  • UPCR was 6 g/g within 4 weeks.

 17Schaubschlager4435/FUSAIgAN, psoriasis

  • SCr: 1.0 mg/dl,

  • UPCR: 0.36 g/g

mRNA (Pfizer)

  • D79 after

  • 2nd dose

SRPUPCR: 2 g/gSCr: 1.1 mg/dlIgAN (M1E1S1T0C1)High-dose steroid + immunosuppressive

  • R.

  • UPCR was 1.14 g/g within 4 weeks.

a

Prednisone was initiated for the treatment of pericarditis.

COVID-19, coronavirus disease 2019; IgAN, IgA nephropathy; F, female; M, male; GH, gross hematuria; SRP, sub-nephrotic range proteinuria; NRP, nephrotic range proteinuria; SCr, serum creatinine; ANA, anti-nuclear antibody; C3, complement C3; CRP, C-reactive protein; ALB, serum albumin; RBC, red blood cell; WBC, white blood cell; HPF, high power field; UPCR, urine protein-to-creatinine ratio; UACR, urinary albumin-creatinine ratio; ACR, microalbumin-creatinine ratio; UTP, 24-h urine protein; CR, complete remission; PR, partial remission; NA, non-applicable; NR, no response; R, response; KT, kidney transplantation; HD, hemodialysis; RASi, renin–angiotensin–aldosterone system inhibition; ABPC, ampicillin; SBT, sulbactam; HTN, hypertension; T1DM, type 1 diabetes mellitus; AIN, acute interstitial nephritis; DPGN, diffuse proliferative glomerulonephritis; APS, antiphospholipid syndrome; GDM, gestational diabetes; AAN, aristolochic acid nephropathy; RF, renal failure; NS, nephrotic syndrome; AKI, acute tubular injury; GERD, gastroesophageal reflux disease; CKD, chronic kidney disease; MEST-C, M = mesangial hypercellularity, E = endocapillary proliferation, S = segmental glomerulosclerosis, T = tubular atrophy/interstitial fibrosis, C = crescents.

Table 2.
Open in new tab

Summary of published cases of IgAN following COVID-19 vaccination

No.AuthorsAge/sexCountry (race)Medical historyBaseline (hhematuria/proteinuria/SCr)VaccineTiming of symptom onsetSymptomsUrinalysisBlood testRenal biopsy (MEST-C)TreatmentsOutcomes
New cases
 1Niel1413/FLuxembourgNoneNAmRNA (Pfizer)< D1 after 1st doseGH, AKI, NRP, fever, asthenia, muscle painproteinuria: 3.9 g/lSCr: 3.57 mg/dlIgAN (M1E1S0T0)Hemodialysis + high-dose steroid

  • R.

  • SCr improved to normal level within D30, microhematuria and a slight proteinuria persisted.

 2Abdel-Qader1512/MJordanianNoneNormalmRNA (Pfizer)< D1 after 1st doseGH, AKI, NRP, HTN, fever, fatigueRBC: 1920/µl, proteinuria: 1.7 g/lSCr: 1.77 mg/dl (D2)IgANHigh-dose steroid

  • R.

  • Remission of GH, AKI, proteinuria within D7

 3Okada1617/FJapanAsymptomatic hematuriaMicroscopic hematuriamRNA (Pfizer)

  • D4 after

  • 1st dose

GH, SRPUPCR: 0.37 g/g

  • SCr: 0.58 mg/dl,

  • IgG: 10.171 g/L,

  • C3: 0.907 g/l

IgAN (M0E0S0T0)Conservative

  • CR.

  • Hematuria changed to microscopic within 1 week, and proteinuria resolved spontaneously with D10 after 2nd dose

 4Fujita1740/FJapanOccult bloodSCr: 0.76 mg/dlmRNA (Pfizer)

  • D9 after

  • 1st dose

  • GH, NRP,

  • fever, chills,

  • shivering, thrombocytopenia, pyuria

  • RBC: 100/HPF,

  • UPCR: 18.13 g/g,

  • WBC: 5–9/HPF

  • SCr: 0.86 mg/dl (D9), 1.23 mg/dl (D15),

  • albumin: >3 g/dl,

  • IgA: 155 mg/dl,

  • C3: 88 mg/dl

IgAN (M1E0S0T0C1)Conservative, plasma exchange, ABPC/SBT

  • CR.

  • Proteinuria spontaneously resolved within D15, GH changed to microscopic within D15, SCr improved to within normal level within later 2 months.

 5Yokote3536/FJapanMicroscopic hematuria, proteinuria, rheumatoid arthritisNAmRNA (Pfizer)

  • D11 after

  • 1st dose

GH, NS

  • UPCR: 15.6 g/g,

  • RBC: >100/HPF

  • SCr: 0.9 mg/dl,

  • ALB: 1.9 g/dl

DPGN, IgAN (M1E1S1T0C0)High-dose steroid + immunosuppressive

  • R.

  • UPCR improved to 2.9 g/g within 4 weeks. RBC and ALB were 30-49/HPF and 3.2 g/dl within 8 weeks, respectively.

 6Klomjit1844/M

  • USA

  • (White)

NASCr: 1.1 mg/dlmRNA (Moderna)

  • D14 after

  • 1st dose

AKI, NRP

  • RBC: 21–30/HPF,

  • UTP: 14 g/d

SCr: 2.5 mg/dlIgAN, AINHigh-dose steroid

  • NR.

  • SCr, RBC and UTP were 3.6 mg/dl, 3-10/HPF and 5.6 g/d within 3 months, respectively.

 7Klomjit1866/M

  • USA

  • (White)

NASCr: 1.1 mg/dlmRNA (Moderna)

  • D14 after

  • 1st dose

  • GH, SNP,

  • pericarditis

  • RBC: 51–100/HPF,

  • UTP: 1.2 g/d

  • SCr: 1.5 mg/dl,

  • 2.2 mg/dl (2nd dose)

IgANPrednisonea

  • R.

  • Scr, RBC and UTP were 1.4 mg/dl, 3–10/HPF and 0.3 g/d within 5 months, respectively.

 8Fenoglio1974/MItalyNANormalAdenovirus vector (AstraZeneca)

  • D42 after

  • 1st dose

RF, NSNANAIgANSteroid + hemodialysis

  • NA

  • Died after 2 months of follow-up to acute heart attack.

 9Fenoglio1979/MItalyNANormalAdenovirus vector (AstraZeneca)

  • D61 after

  • 1st dose

RF, NSNANAIgAN

  • Steroid +

  • immunosuppressive

NA
 10Anderegg2039/MSwitzerlandHTNNAmRNA (Moderna)

  • Immediate after 2nd dose

GH, AKI, SRP, flu-like symptoms, severe feverNumerous RBCAKIIgANHigh-dose steroid + immunosuppressive

  • R.

  • SCr was normalized and proteinuria significantly decreased, but microhematuria persisted within several weeks

 11Lo2128/FChinaMicroscopic hematuria

  • SCr: 0.66 mg/dl,

  • UPCR: 20

  • mg/mmol

mRNA (Pfizer)

  • 3 h after

  • 2nd dose

GH, SRP

  • UPCR: 320

  • mg/mmol

  • SCr: 0.81 mg/dl,

  • ANA: 1:640

IgAN (M1E0S0T0C0)Conservative

  • CR.

  • SCr improved to within normal level and hematuria subsided spontaneously in D5, UPCR fell to 34 mg/mmol and ANA became negative within 3 weeks

 12Yotoke3519/MJapanMicroscopic hematuriaNAmRNA (Pfizer)

  • 18h after

  • 2nd dose

GH

  • RBC: 50–99/HPF,

  • UPCR: 1.5 g/g

SCr: 0.97 mg/dlDPGN, IgAN (M1E1S1T0C1)RASi

  • R.

  • UPCR improved to <1 g/g within 12 weeks.

 13Hanna2217/M

  • USA

  • (White)

Foamy urineNAmRNA (Pfizer)< D1 after 2nd doseGH, AKI, SRP, HTN grade 1UPCR: 1.75 g/g (D9)

  • SCr: 1.78 mg/dl (D6),

  • ALB: 3.8 g/dl

IgAN (M1E1S1T1C1)High-dose steroid

  • R.

  • Hematuria self-resolved in D4 and SCr improved to 1.2 mg/dl at D22

 14Abramson2330/MUSA (European and American ancestry)NoneNAmRNA (Moderna)

  • D1 after

  • 2nd dose

  • SRP, fevers,

  • chills, headache, brown-colored urine

  • UPCR: 0.8 g/g,

  • RBC: >30/HPF,

  • WBC: 11–30/HPF

  • SCr: 1.02 mg/dl,

  • IgA: 444 mg/dl

IgAN (M1E0S1T0C0)RASi

  • R.

  • GH changed to microscopic within D2, UPCR improved to 0.43 g/g within 6 weeks

 15Tan2441/FChineseGDMNormalmRNA (Pfizer)

  • D1 after

  • 2nd dose

AKI, GH, SRP, HTN grade 1, headache, generalized myalgia

  • RBC: >200 μl,

  • UPCR: 2.03 g/g

  • SCr: 1.73 mg/dl,

  • IgG : 12.9 g/l,

  • C3:0.83 g/l,

  • ANA : 1:320

IgANHigh-dose steroid + immunosuppressiveNA.
 16Leong2526/MSingaporeSuspected IgAN

  • SCr: 0.85 mg/dl,

  • UPCR: 74 mg/mmol

mRNA (Pfizer)

  • D1 after

  • 2nd dose

GH, AKI, SRP, feverUPCR: 174 mg/mmol, RBC: >100/HPF

  • SCr: 1.62 mg/dl,

  • ALB: 4 g/dl

IgANRASiNA
 17Park2650/MUSA

  • HTN, CKD,

  • mild proteinuria

  • SCr: 1.17 mg/dl,

  • RBC: 11–25/HPF,

  • UPCR: 2.4 g/g

mRNA (Moderna)

  • D1 after

  • 2nd dose

GH, AKI, NRP

  • RBC: >50/HPF,

  • UPRC: 3.56 g/g,

SCr: 1.54 mg/dlIgANRASi

  • R.

  • RBC, UPCR and SCr were 11–25/HPF, 2.2 g/g, 1.24 mg/dl following up 1 month, respectively.

 18Lim2742/FKoreaNoneNAmRNA (Moderna)

  • D1 after

  • 2nd dose

GHUTP :1.7 g/dSCr: 0.47 mg/dlIgAN (M0E1C1S1T0)RASi

  • PR.

  • GH disappeared within several days, but microhematuria and proteinuria persisted.

 19Uchiyama3615/MJapanMicroscopic hematuriaNAmRNA (Pfizer)

  • D1 after

  • 2nd dose

GH, fever, myalgia

  • UPCR: 0.9 g/g,

  • numerous RBC

SCr: 0.97 mg/dlIgAN (M1E0S0T0C1)Conservative

  • R.

  • GH spontaneously resolved within D6. Microhematuria and proteinuria persisted.

 20Uchiyama3618/MJapanMicroscopic hematuriaNAmRNA (Pfizer)

  • D2 after

  • 2nd dose

GH, fever, general malaise

  • UPCR: 0.4 g/g

  • numerous RBC

SCr: 0.82 mg/dlIgAN (M1E0S0T0C0)Conservative

  • R.

  • GH spontaneously resolved within D7. Microhematuria and proteinuria disappeared gradually.

 21Kudose2850/F

  • USA

  • (White)

  • HTN, APS,

  • obesity

  • SCr: 1.3 mg/dl,

  • RBC: 10–20/HPF,

  • UPCR: 1.3 g/g

mRNA (Moderna)

  • D2 after

  • 2nd dose

GH, AKI, SRP, fever, body aches

  • UPCR: 2 g/g,

  • RBC: >50/HPF

SCr: 1.7 mg/dlIgAN (M1E0S1T1C1)Conservative

  • R.

  • Hematuria resolved within D5.

 22Kudose2819/M

  • USA

  • (White)

Microscopic hematuriaNormalmRNA (Moderna)

  • D2 after

  • 2nd dose

GHnumerous RBCSCr: 1.2 mg/dlIgAN (M1E1S1T0C0)Conservative

  • R.

  • Hematuria resolved within D2.

 23Horino2917/MJapanMicroscopic hematuriaNAmRNA (Pfizer)

  • D2 after

  • 2nd dose

  • GH, SRP,

  • fever, headache,

  • UPCR: 1.0 g/g,

  • RBC: >100/HPF

  • SCr: 0.70 mg/dl,

  • CRP: 2.41 mg/dl

IgAN

  • Tonsillectomy +

  • high-dose steroid

  • PR.

  • Proteinuria and microhematuria persisted within 2 months later

 24Srinivasan3035/MUSA (Caucasian)Nephrolithiasis, ulcerative colitisSCr: 1 mg/dlmRNA (Moderna)

  • D2 after

  • 2nd dose

GH, AKI, SRPUPCR: 0.656 g/gSCr: 1.3 mg/dlIgAN (M1E1S0T0C1)Immunosuppressive

  • PR.

  • Hematuria resolved, SCr and UPCR returned to stable but not back to baseline within 4 weeks

 25Morisawa3116/MJapanAsymptomatic hematuria

  • SCr: 0.87 mg/dl,

  • RBC: 50–100/HPF,

  • UPCR: 0.03 g/g

mRNA (Pfizer)

  • D2 after

  • 2nd dose

GH, AKI, SRP, fever

  • UPCR:

  • 0.28 g/g (D6),

  • 0.35 g/g (D21)

  • SCr: 1.1 mg/dl (D6), 1.26 mg/dl (D20),

  • 1.29 mg/dl (D55)

IgAN (M0E1S0T0C1)

  • Steroid +

  • immunosuppressive

  • R

  • Remission of GH after D3, AKI after 3 months

 26Morisawa3113/FJapanAsymptomatic hematuria

  • SCr: 0.51 mg/dl,

  • RBC: 10–20/HPF,

  • UPCR: 0.08 g/g

mRNA (Pfizer)

  • D2 after

  • 2nd dose

GH, SRP, fever

  • UPCR: 1.99 g/g

  • (D7)

SCr: 0.54 mg/dlIgAN (M0E0S0T0C0)Conservation

  • R

  • Resolved of UPCR in 26 days.

 27Nihei3228/FJapanGH and mild proteinuria in 17 years oldNAmRNA (Pfizer)

  • D7 after

  • 2nd dose

GH

  • RBC: >100/HPF,

  • UPCR: 0.13 g/g,

  • Gd-IgA1: 23

  • ng/ml

  • C3: 85 U/L,

  • IgA: 283 mg/dl,

  • SCr: 0.7 mg/dl,

  • Gd-IgA1: 4 µg/ml

IgAN (M0S0E1T0C0)Conservative

  • CR

  • Proteinuria and hematuria resolved in 28 days.

 28Klomjit1838/M

  • USA

  • (White)

NASCr: 1.3 mg/dlmRNA (Pfizer)

  • D14 after

  • 2nd dose

GH, SRPRBC : 51–100/HPF UTP: 0.32 g/dSCr: 1.6 mg/dlIgANConservativeNA
 29Alonso3430/MSpain

  • Membranous proliferative glomerulonephritis type 1, CKD,

  • KT (2019)

  • SCr: 1.1 mg/dl,

  • UACR: 0.45 g/g

mRNA (Pfizer)

  • D34 after

  • 2nd dose

Microscopic hematuria

  • UACR: 0.4 g/g,

  • hematuria: 150/µl

  • SCr: 1.65 mg/dl,

  • 2.4 mg/dl (D50)

IgANSteroid

  • NR.

  • Hematuria, UACR and SCr were 30/µl, 0.47 g/g and 1.9 mg/dl within after 2 months, respectively.

 30Mokos3373/MCroatiaAAN, HTN, KTUTP: 0.25 g/dAdenovirus vector (AstraZeneca)

  • D35 after

  • 2nd dose

SRP, edema of the lower legs

  • UTP: 1.4 g/d,

  • RBC: 3–5/HPF

SCr: 1.67 mg/dlIgAN (M0E1S0T0C1)RASi

  • Progressed.

  • UTP and RBC were 1.9 g/d, 5–10/HP during the next 3 weeks, respectively.

 31Klomjit1862/M

  • USA

  • (White)

NASCr: 1.0 mg/dlmRNA (Pfizer)

  • D42 after

  • 2nd dose

AKI, SRP

  • RBC: 31–40/HPF,

  • UTP: 0.9 g/d

SCr: 2.2 mg/dlIgANConservative

  • R.

  • SCr, RBC and UTP were 2.0 mg/dl, <3/HPF and 0.2 g/d within 1.5 months, respectively

Relapsed cases
 1Perrin3741/FFrance

  • IgAN (2005),

  • KT (2013)

Microscopic hematuriamRNA (Pfizer)

  • D2 after

  • 1st dose

  • GH, SRP,

  • marked leukocytosis

  • UPCR: 0.47 g/g,

  • numerous RBC

  • SCr transiently

  • increased

IgANConservative

  • CR.

  • Symptoms spontaneously resolved.

 2Horino3846/FJapanIgAN, tonsillectomy

  • SCr was normal,

  • RBC: <5/HPF

mRNA (Pfizer)

  • 12h after

  • 2nd dose

  • GH, SRP,

  • fever, myalgia

  • proteinuria: 3+,

  • RBC: >100/HPF

SCr was normalIgANConservative

  • PR.

  • Proteinuria spontaneously resolved within 2 weeks, GH changed to microscopic within 2 weeks.

 3Negrea3938/F

  • USA

  • (White)

IgAN (2005)

  • UTP: 0.63 g/d,

  • Microscopic hematuria

mRNA (Moderna)8–24 h after 2nd dose

  • GH, SRP,

  • fever, body

  • aches, chills,

  • headache, fatigue

UTP: 0.82 g/dSCr was normalIgANConservative

  • PR.

  • Hematuria spontaneously resolved in 3 d, proteinuria was 1.4 g/d within 3 weeks.

 4Negrea3938/F

  • USA

  • (White)

IgAN (2019)

  • UTP: 0.43 g/d,

  • Microscopic hematuria

mRNA (Moderna)

  • 8–24 h after 2nd

  • dose

  • GH, SRP,

  • fever, body

  • aches, chills,

  • headache, fatigue

UTP: 0.59 g/dSCr was normalIgANConservative

  • CR.

  • Hematuria spontaneously resolved in 3 d, proteinuria was 0.4 g/d within 3 weeks.

 5Valenzuela4536/FSpainIgAN (2020)

  • SCr: 0.9 mg/dl,

  • UTP: 0.7 g/d,

  • Microhematuria

mRNA (Moderna)Few hours after 2nd doseGH, AKI, fever, malaiseUTP: 1.5 g/d

  • SCr: 1.8 mg/dl,

  • IgA: 2174 mg/l

IgANHigh-dose steroid + immunosuppressive

  • R.

  • SCr and proteinuria were 1.09 mg/dl and 0.5 g/d after 2 months, respectively.

 6Rahim4052/FAsianIgAN (2017)ACR: <1 g/gmRAN (Pfizer)

  • < D1 after

  • 2nd dose

  • GH, SRP,

  • fever, generalized myalgias, lumbago bilaterally

  • numerous RBC,

  • ACR: 2.4 g/g

NAIgANConservative

  • CR.

  • Hematuria resolved within 1 week, ACR was 1.44 g/g within D5.

 7Plasse41NAUSAIgAN (2020)

  • SCr: 1.0 mg/dl,

  • UPCR: 0.61 mg/g

mRNA (Pfizer)< D1 after 2nd dose

  • GH, body

  • aches

  • UPCR: 0.92 mg/g,

  • numerous RBC

SCr: 1.16 mg/dlIgANConservative

  • CR.

  • Hematuria resolved within D3.

 8Hanna2213/M

  • USA

  • (White)

IgAN, T1DM

  • SCr: 0.54 mg/dl,

  • UPCR: 1.6 g/g,

  • ALB: 3.4 g/dl

mRNA (Pfizer)< D1 after 2nd doseGH, SRP, AKI, vomiting

  • UPCR: 1.07 g/g,

  • numerous RBC

SCr: 1.31 mg/dl (D2), ALB: 3.8 g/dl

  • IgAN

  • (M0E0S0T0C0)

Conservative

  • CR.

  • Hematuria and AKI resolved within D6, UPCR was 0.86 g/g (D6).

 9Srinivasan3025/FEuropeanIgAN

  • SCr: 0.7 mg/dl,

  • UPCR: 1.41 g/g

mRNA (Moderna)

  • D1 after

  • 2nd dose

GH, AKI, NRPUPCR: 4.76 g/gSCr: 1.07 mg/dlIgANConservative

  • CR.

  • Hematuria resolved, SCr and UPCR returned to baseline within 3 weeks.

 10Perrin3727/FFrance

  • IgAN (2020),

  • HD

NormalmRNA (Pfizer)

  • D2 after

  • 2nd dose

  • GH, SRP,

  • abdominal pain, urticaria at D5,

  • moderate pancytopenia,

  • UPCR: 1.9 g/g,

  • numerous RBC

NAIgANConservative

  • R.

  • Symptoms spontaneously resolved, UPCR was 1.2 g/g within 1 month after 2nd dose.

 11Watanabe4254/FUSA (Caucasian)

  • IgAN (2006),

  • obesity, HTN,

  • GERD

  • SCr: 1.2 mg/dl,

  • UPCR: 1.03 g/g,

  • RBC: 15/HPF

mRNA (Moderna)

  • D2 after

  • 2nd dose

GH, AKI, SRP

  • RBC: 50/HPF,

  • UPCR: 0.67 g/g

SCr: 3.04 mg/dl (D7)Active IgANSteroids

  • R.

  • Remission of GH after 2 days, AKI in 3 months.

 12Udagawa4315/FJapanIgANNAmRNA (Pfizer)

  • D2 after

  • 2nd dose

GH, SRP, fever

  • numerous RBC,

  • mild proteinuria

SCr was normalIgANConservation

  • R.

  • Remission of GH after 3 days.

 13Udagawa4316/FJapanIgANNormalmRNA (Pfizer)

  • D3 after

  • 2nd dose

  • GH, fever,

  • headache

numerous RBCSCr was normalIgANConservation

  • R.

  • Remission of GH after 2 days.

 14Plasse41NAUSAIgAN (2018)

  • SCr: 0.8 mg/dl,

  • UPCR: 1.56 mg/g

mRNA (Pfizer)

  • D5 after

  • 2nd dose

  • GH, AKI,

  • fevers, chills,

  • body aches,

  • dysuria

  • UPCR: 3.0 mg/g,

  • numerous RBC

SCr: 3.53 mg/dlIgANSteroids

  • R.

  • SCr and proteinuria

  • recovered baseline within 1 month and 2 months, respectively.

 15Klomjit1819/M

  • USA

  • (White)

IgANSCr: 0.96 mg/dlmRNA (Moderna)

  • D7 after

  • 2nd dose

GH, SRP

  • RBC: 50–100/HPF,

  • UTP: 0.61 g/d

SCr: 0.76 mg/dlIgANConservativeNA.
 16Yokote3548/FJapanIgAN (M0E1S1T0C1), tonsillectomyUTP: 0.91 g/dmRNA (Pfizer)

  • D14 after

  • 2nd dose

NS, GH

  • RBC: >100/HPF,

  • UPCR: 19.05 g/g

  • SCr: 0.94 mg/dl

  • ALB: 2.2 g/dl

DPGN, IgAN (M0E1S1T0C1)High-dose steroid

  • PR.

  • UPCR was 6 g/g within 4 weeks.

 17Schaubschlager4435/FUSAIgAN, psoriasis

  • SCr: 1.0 mg/dl,

  • UPCR: 0.36 g/g

mRNA (Pfizer)

  • D79 after

  • 2nd dose

SRPUPCR: 2 g/gSCr: 1.1 mg/dlIgAN (M1E1S1T0C1)High-dose steroid + immunosuppressive

  • R.

  • UPCR was 1.14 g/g within 4 weeks.

No.AuthorsAge/sexCountry (race)Medical historyBaseline (hhematuria/proteinuria/SCr)VaccineTiming of symptom onsetSymptomsUrinalysisBlood testRenal biopsy (MEST-C)TreatmentsOutcomes
New cases
 1Niel1413/FLuxembourgNoneNAmRNA (Pfizer)< D1 after 1st doseGH, AKI, NRP, fever, asthenia, muscle painproteinuria: 3.9 g/lSCr: 3.57 mg/dlIgAN (M1E1S0T0)Hemodialysis + high-dose steroid

  • R.

  • SCr improved to normal level within D30, microhematuria and a slight proteinuria persisted.

 2Abdel-Qader1512/MJordanianNoneNormalmRNA (Pfizer)< D1 after 1st doseGH, AKI, NRP, HTN, fever, fatigueRBC: 1920/µl, proteinuria: 1.7 g/lSCr: 1.77 mg/dl (D2)IgANHigh-dose steroid

  • R.

  • Remission of GH, AKI, proteinuria within D7

 3Okada1617/FJapanAsymptomatic hematuriaMicroscopic hematuriamRNA (Pfizer)

  • D4 after

  • 1st dose

GH, SRPUPCR: 0.37 g/g

  • SCr: 0.58 mg/dl,

  • IgG: 10.171 g/L,

  • C3: 0.907 g/l

IgAN (M0E0S0T0)Conservative

  • CR.

  • Hematuria changed to microscopic within 1 week, and proteinuria resolved spontaneously with D10 after 2nd dose

 4Fujita1740/FJapanOccult bloodSCr: 0.76 mg/dlmRNA (Pfizer)

  • D9 after

  • 1st dose

  • GH, NRP,

  • fever, chills,

  • shivering, thrombocytopenia, pyuria

  • RBC: 100/HPF,

  • UPCR: 18.13 g/g,

  • WBC: 5–9/HPF

  • SCr: 0.86 mg/dl (D9), 1.23 mg/dl (D15),

  • albumin: >3 g/dl,

  • IgA: 155 mg/dl,

  • C3: 88 mg/dl

IgAN (M1E0S0T0C1)Conservative, plasma exchange, ABPC/SBT

  • CR.

  • Proteinuria spontaneously resolved within D15, GH changed to microscopic within D15, SCr improved to within normal level within later 2 months.

 5Yokote3536/FJapanMicroscopic hematuria, proteinuria, rheumatoid arthritisNAmRNA (Pfizer)

  • D11 after

  • 1st dose

GH, NS

  • UPCR: 15.6 g/g,

  • RBC: >100/HPF

  • SCr: 0.9 mg/dl,

  • ALB: 1.9 g/dl

DPGN, IgAN (M1E1S1T0C0)High-dose steroid + immunosuppressive

  • R.

  • UPCR improved to 2.9 g/g within 4 weeks. RBC and ALB were 30-49/HPF and 3.2 g/dl within 8 weeks, respectively.

 6Klomjit1844/M

  • USA

  • (White)

NASCr: 1.1 mg/dlmRNA (Moderna)

  • D14 after

  • 1st dose

AKI, NRP

  • RBC: 21–30/HPF,

  • UTP: 14 g/d

SCr: 2.5 mg/dlIgAN, AINHigh-dose steroid

  • NR.

  • SCr, RBC and UTP were 3.6 mg/dl, 3-10/HPF and 5.6 g/d within 3 months, respectively.

 7Klomjit1866/M

  • USA

  • (White)

NASCr: 1.1 mg/dlmRNA (Moderna)

  • D14 after

  • 1st dose

  • GH, SNP,

  • pericarditis

  • RBC: 51–100/HPF,

  • UTP: 1.2 g/d

  • SCr: 1.5 mg/dl,

  • 2.2 mg/dl (2nd dose)

IgANPrednisonea

  • R.

  • Scr, RBC and UTP were 1.4 mg/dl, 3–10/HPF and 0.3 g/d within 5 months, respectively.

 8Fenoglio1974/MItalyNANormalAdenovirus vector (AstraZeneca)

  • D42 after

  • 1st dose

RF, NSNANAIgANSteroid + hemodialysis

  • NA

  • Died after 2 months of follow-up to acute heart attack.

 9Fenoglio1979/MItalyNANormalAdenovirus vector (AstraZeneca)

  • D61 after

  • 1st dose

RF, NSNANAIgAN

  • Steroid +

  • immunosuppressive

NA
 10Anderegg2039/MSwitzerlandHTNNAmRNA (Moderna)

  • Immediate after 2nd dose

GH, AKI, SRP, flu-like symptoms, severe feverNumerous RBCAKIIgANHigh-dose steroid + immunosuppressive

  • R.

  • SCr was normalized and proteinuria significantly decreased, but microhematuria persisted within several weeks

 11Lo2128/FChinaMicroscopic hematuria

  • SCr: 0.66 mg/dl,

  • UPCR: 20

  • mg/mmol

mRNA (Pfizer)

  • 3 h after

  • 2nd dose

GH, SRP

  • UPCR: 320

  • mg/mmol

  • SCr: 0.81 mg/dl,

  • ANA: 1:640

IgAN (M1E0S0T0C0)Conservative

  • CR.

  • SCr improved to within normal level and hematuria subsided spontaneously in D5, UPCR fell to 34 mg/mmol and ANA became negative within 3 weeks

 12Yotoke3519/MJapanMicroscopic hematuriaNAmRNA (Pfizer)

  • 18h after

  • 2nd dose

GH

  • RBC: 50–99/HPF,

  • UPCR: 1.5 g/g

SCr: 0.97 mg/dlDPGN, IgAN (M1E1S1T0C1)RASi

  • R.

  • UPCR improved to <1 g/g within 12 weeks.

 13Hanna2217/M

  • USA

  • (White)

Foamy urineNAmRNA (Pfizer)< D1 after 2nd doseGH, AKI, SRP, HTN grade 1UPCR: 1.75 g/g (D9)

  • SCr: 1.78 mg/dl (D6),

  • ALB: 3.8 g/dl

IgAN (M1E1S1T1C1)High-dose steroid

  • R.

  • Hematuria self-resolved in D4 and SCr improved to 1.2 mg/dl at D22

 14Abramson2330/MUSA (European and American ancestry)NoneNAmRNA (Moderna)

  • D1 after

  • 2nd dose

  • SRP, fevers,

  • chills, headache, brown-colored urine

  • UPCR: 0.8 g/g,

  • RBC: >30/HPF,

  • WBC: 11–30/HPF

  • SCr: 1.02 mg/dl,

  • IgA: 444 mg/dl

IgAN (M1E0S1T0C0)RASi

  • R.

  • GH changed to microscopic within D2, UPCR improved to 0.43 g/g within 6 weeks

 15Tan2441/FChineseGDMNormalmRNA (Pfizer)

  • D1 after

  • 2nd dose

AKI, GH, SRP, HTN grade 1, headache, generalized myalgia

  • RBC: >200 μl,

  • UPCR: 2.03 g/g

  • SCr: 1.73 mg/dl,

  • IgG : 12.9 g/l,

  • C3:0.83 g/l,

  • ANA : 1:320

IgANHigh-dose steroid + immunosuppressiveNA.
 16Leong2526/MSingaporeSuspected IgAN

  • SCr: 0.85 mg/dl,

  • UPCR: 74 mg/mmol

mRNA (Pfizer)

  • D1 after

  • 2nd dose

GH, AKI, SRP, feverUPCR: 174 mg/mmol, RBC: >100/HPF

  • SCr: 1.62 mg/dl,

  • ALB: 4 g/dl

IgANRASiNA
 17Park2650/MUSA

  • HTN, CKD,

  • mild proteinuria

  • SCr: 1.17 mg/dl,

  • RBC: 11–25/HPF,

  • UPCR: 2.4 g/g

mRNA (Moderna)

  • D1 after

  • 2nd dose

GH, AKI, NRP

  • RBC: >50/HPF,

  • UPRC: 3.56 g/g,

SCr: 1.54 mg/dlIgANRASi

  • R.

  • RBC, UPCR and SCr were 11–25/HPF, 2.2 g/g, 1.24 mg/dl following up 1 month, respectively.

 18Lim2742/FKoreaNoneNAmRNA (Moderna)

  • D1 after

  • 2nd dose

GHUTP :1.7 g/dSCr: 0.47 mg/dlIgAN (M0E1C1S1T0)RASi

  • PR.

  • GH disappeared within several days, but microhematuria and proteinuria persisted.

 19Uchiyama3615/MJapanMicroscopic hematuriaNAmRNA (Pfizer)

  • D1 after

  • 2nd dose

GH, fever, myalgia

  • UPCR: 0.9 g/g,

  • numerous RBC

SCr: 0.97 mg/dlIgAN (M1E0S0T0C1)Conservative

  • R.

  • GH spontaneously resolved within D6. Microhematuria and proteinuria persisted.

 20Uchiyama3618/MJapanMicroscopic hematuriaNAmRNA (Pfizer)

  • D2 after

  • 2nd dose

GH, fever, general malaise

  • UPCR: 0.4 g/g

  • numerous RBC

SCr: 0.82 mg/dlIgAN (M1E0S0T0C0)Conservative

  • R.

  • GH spontaneously resolved within D7. Microhematuria and proteinuria disappeared gradually.

 21Kudose2850/F

  • USA

  • (White)

  • HTN, APS,

  • obesity

  • SCr: 1.3 mg/dl,

  • RBC: 10–20/HPF,

  • UPCR: 1.3 g/g

mRNA (Moderna)

  • D2 after

  • 2nd dose

GH, AKI, SRP, fever, body aches

  • UPCR: 2 g/g,

  • RBC: >50/HPF

SCr: 1.7 mg/dlIgAN (M1E0S1T1C1)Conservative

  • R.

  • Hematuria resolved within D5.

 22Kudose2819/M

  • USA

  • (White)

Microscopic hematuriaNormalmRNA (Moderna)

  • D2 after

  • 2nd dose

GHnumerous RBCSCr: 1.2 mg/dlIgAN (M1E1S1T0C0)Conservative

  • R.

  • Hematuria resolved within D2.

 23Horino2917/MJapanMicroscopic hematuriaNAmRNA (Pfizer)

  • D2 after

  • 2nd dose

  • GH, SRP,

  • fever, headache,

  • UPCR: 1.0 g/g,

  • RBC: >100/HPF

  • SCr: 0.70 mg/dl,

  • CRP: 2.41 mg/dl

IgAN

  • Tonsillectomy +

  • high-dose steroid

  • PR.

  • Proteinuria and microhematuria persisted within 2 months later

 24Srinivasan3035/MUSA (Caucasian)Nephrolithiasis, ulcerative colitisSCr: 1 mg/dlmRNA (Moderna)

  • D2 after

  • 2nd dose

GH, AKI, SRPUPCR: 0.656 g/gSCr: 1.3 mg/dlIgAN (M1E1S0T0C1)Immunosuppressive

  • PR.

  • Hematuria resolved, SCr and UPCR returned to stable but not back to baseline within 4 weeks

 25Morisawa3116/MJapanAsymptomatic hematuria

  • SCr: 0.87 mg/dl,

  • RBC: 50–100/HPF,

  • UPCR: 0.03 g/g

mRNA (Pfizer)

  • D2 after

  • 2nd dose

GH, AKI, SRP, fever

  • UPCR:

  • 0.28 g/g (D6),

  • 0.35 g/g (D21)

  • SCr: 1.1 mg/dl (D6), 1.26 mg/dl (D20),

  • 1.29 mg/dl (D55)

IgAN (M0E1S0T0C1)

  • Steroid +

  • immunosuppressive

  • R

  • Remission of GH after D3, AKI after 3 months

 26Morisawa3113/FJapanAsymptomatic hematuria

  • SCr: 0.51 mg/dl,

  • RBC: 10–20/HPF,

  • UPCR: 0.08 g/g

mRNA (Pfizer)

  • D2 after

  • 2nd dose

GH, SRP, fever

  • UPCR: 1.99 g/g

  • (D7)

SCr: 0.54 mg/dlIgAN (M0E0S0T0C0)Conservation

  • R

  • Resolved of UPCR in 26 days.

 27Nihei3228/FJapanGH and mild proteinuria in 17 years oldNAmRNA (Pfizer)

  • D7 after

  • 2nd dose

GH

  • RBC: >100/HPF,

  • UPCR: 0.13 g/g,

  • Gd-IgA1: 23

  • ng/ml

  • C3: 85 U/L,

  • IgA: 283 mg/dl,

  • SCr: 0.7 mg/dl,

  • Gd-IgA1: 4 µg/ml

IgAN (M0S0E1T0C0)Conservative

  • CR

  • Proteinuria and hematuria resolved in 28 days.

 28Klomjit1838/M

  • USA

  • (White)

NASCr: 1.3 mg/dlmRNA (Pfizer)

  • D14 after

  • 2nd dose

GH, SRPRBC : 51–100/HPF UTP: 0.32 g/dSCr: 1.6 mg/dlIgANConservativeNA
 29Alonso3430/MSpain

  • Membranous proliferative glomerulonephritis type 1, CKD,

  • KT (2019)

  • SCr: 1.1 mg/dl,

  • UACR: 0.45 g/g

mRNA (Pfizer)

  • D34 after

  • 2nd dose

Microscopic hematuria

  • UACR: 0.4 g/g,

  • hematuria: 150/µl

  • SCr: 1.65 mg/dl,

  • 2.4 mg/dl (D50)

IgANSteroid

  • NR.

  • Hematuria, UACR and SCr were 30/µl, 0.47 g/g and 1.9 mg/dl within after 2 months, respectively.

 30Mokos3373/MCroatiaAAN, HTN, KTUTP: 0.25 g/dAdenovirus vector (AstraZeneca)

  • D35 after

  • 2nd dose

SRP, edema of the lower legs

  • UTP: 1.4 g/d,

  • RBC: 3–5/HPF

SCr: 1.67 mg/dlIgAN (M0E1S0T0C1)RASi

  • Progressed.

  • UTP and RBC were 1.9 g/d, 5–10/HP during the next 3 weeks, respectively.

 31Klomjit1862/M

  • USA

  • (White)

NASCr: 1.0 mg/dlmRNA (Pfizer)

  • D42 after

  • 2nd dose

AKI, SRP

  • RBC: 31–40/HPF,

  • UTP: 0.9 g/d

SCr: 2.2 mg/dlIgANConservative

  • R.

  • SCr, RBC and UTP were 2.0 mg/dl, <3/HPF and 0.2 g/d within 1.5 months, respectively

Relapsed cases
 1Perrin3741/FFrance

  • IgAN (2005),

  • KT (2013)

Microscopic hematuriamRNA (Pfizer)

  • D2 after

  • 1st dose

  • GH, SRP,

  • marked leukocytosis

  • UPCR: 0.47 g/g,

  • numerous RBC

  • SCr transiently

  • increased

IgANConservative

  • CR.

  • Symptoms spontaneously resolved.

 2Horino3846/FJapanIgAN, tonsillectomy

  • SCr was normal,

  • RBC: <5/HPF

mRNA (Pfizer)

  • 12h after

  • 2nd dose

  • GH, SRP,

  • fever, myalgia

  • proteinuria: 3+,

  • RBC: >100/HPF

SCr was normalIgANConservative

  • PR.

  • Proteinuria spontaneously resolved within 2 weeks, GH changed to microscopic within 2 weeks.

 3Negrea3938/F

  • USA

  • (White)

IgAN (2005)

  • UTP: 0.63 g/d,

  • Microscopic hematuria

mRNA (Moderna)8–24 h after 2nd dose

  • GH, SRP,

  • fever, body

  • aches, chills,

  • headache, fatigue

UTP: 0.82 g/dSCr was normalIgANConservative

  • PR.

  • Hematuria spontaneously resolved in 3 d, proteinuria was 1.4 g/d within 3 weeks.

 4Negrea3938/F

  • USA

  • (White)

IgAN (2019)

  • UTP: 0.43 g/d,

  • Microscopic hematuria

mRNA (Moderna)

  • 8–24 h after 2nd

  • dose

  • GH, SRP,

  • fever, body

  • aches, chills,

  • headache, fatigue

UTP: 0.59 g/dSCr was normalIgANConservative

  • CR.

  • Hematuria spontaneously resolved in 3 d, proteinuria was 0.4 g/d within 3 weeks.

 5Valenzuela4536/FSpainIgAN (2020)

  • SCr: 0.9 mg/dl,

  • UTP: 0.7 g/d,

  • Microhematuria

mRNA (Moderna)Few hours after 2nd doseGH, AKI, fever, malaiseUTP: 1.5 g/d

  • SCr: 1.8 mg/dl,

  • IgA: 2174 mg/l

IgANHigh-dose steroid + immunosuppressive

  • R.

  • SCr and proteinuria were 1.09 mg/dl and 0.5 g/d after 2 months, respectively.

 6Rahim4052/FAsianIgAN (2017)ACR: <1 g/gmRAN (Pfizer)

  • < D1 after

  • 2nd dose

  • GH, SRP,

  • fever, generalized myalgias, lumbago bilaterally

  • numerous RBC,

  • ACR: 2.4 g/g

NAIgANConservative

  • CR.

  • Hematuria resolved within 1 week, ACR was 1.44 g/g within D5.

 7Plasse41NAUSAIgAN (2020)

  • SCr: 1.0 mg/dl,

  • UPCR: 0.61 mg/g

mRNA (Pfizer)< D1 after 2nd dose

  • GH, body

  • aches

  • UPCR: 0.92 mg/g,

  • numerous RBC

SCr: 1.16 mg/dlIgANConservative

  • CR.

  • Hematuria resolved within D3.

 8Hanna2213/M

  • USA

  • (White)

IgAN, T1DM

  • SCr: 0.54 mg/dl,

  • UPCR: 1.6 g/g,

  • ALB: 3.4 g/dl

mRNA (Pfizer)< D1 after 2nd doseGH, SRP, AKI, vomiting

  • UPCR: 1.07 g/g,

  • numerous RBC

SCr: 1.31 mg/dl (D2), ALB: 3.8 g/dl

  • IgAN

  • (M0E0S0T0C0)

Conservative

  • CR.

  • Hematuria and AKI resolved within D6, UPCR was 0.86 g/g (D6).

 9Srinivasan3025/FEuropeanIgAN

  • SCr: 0.7 mg/dl,

  • UPCR: 1.41 g/g

mRNA (Moderna)

  • D1 after

  • 2nd dose

GH, AKI, NRPUPCR: 4.76 g/gSCr: 1.07 mg/dlIgANConservative

  • CR.

  • Hematuria resolved, SCr and UPCR returned to baseline within 3 weeks.

 10Perrin3727/FFrance

  • IgAN (2020),

  • HD

NormalmRNA (Pfizer)

  • D2 after

  • 2nd dose

  • GH, SRP,

  • abdominal pain, urticaria at D5,

  • moderate pancytopenia,

  • UPCR: 1.9 g/g,

  • numerous RBC

NAIgANConservative

  • R.

  • Symptoms spontaneously resolved, UPCR was 1.2 g/g within 1 month after 2nd dose.

 11Watanabe4254/FUSA (Caucasian)

  • IgAN (2006),

  • obesity, HTN,

  • GERD

  • SCr: 1.2 mg/dl,

  • UPCR: 1.03 g/g,

  • RBC: 15/HPF

mRNA (Moderna)

  • D2 after

  • 2nd dose

GH, AKI, SRP

  • RBC: 50/HPF,

  • UPCR: 0.67 g/g

SCr: 3.04 mg/dl (D7)Active IgANSteroids

  • R.

  • Remission of GH after 2 days, AKI in 3 months.

 12Udagawa4315/FJapanIgANNAmRNA (Pfizer)

  • D2 after

  • 2nd dose

GH, SRP, fever

  • numerous RBC,

  • mild proteinuria

SCr was normalIgANConservation

  • R.

  • Remission of GH after 3 days.

 13Udagawa4316/FJapanIgANNormalmRNA (Pfizer)

  • D3 after

  • 2nd dose

  • GH, fever,

  • headache

numerous RBCSCr was normalIgANConservation

  • R.

  • Remission of GH after 2 days.

 14Plasse41NAUSAIgAN (2018)

  • SCr: 0.8 mg/dl,

  • UPCR: 1.56 mg/g

mRNA (Pfizer)

  • D5 after

  • 2nd dose

  • GH, AKI,

  • fevers, chills,

  • body aches,

  • dysuria

  • UPCR: 3.0 mg/g,

  • numerous RBC

SCr: 3.53 mg/dlIgANSteroids

  • R.

  • SCr and proteinuria

  • recovered baseline within 1 month and 2 months, respectively.

 15Klomjit1819/M

  • USA

  • (White)

IgANSCr: 0.96 mg/dlmRNA (Moderna)

  • D7 after

  • 2nd dose

GH, SRP

  • RBC: 50–100/HPF,

  • UTP: 0.61 g/d

SCr: 0.76 mg/dlIgANConservativeNA.
 16Yokote3548/FJapanIgAN (M0E1S1T0C1), tonsillectomyUTP: 0.91 g/dmRNA (Pfizer)

  • D14 after

  • 2nd dose

NS, GH

  • RBC: >100/HPF,

  • UPCR: 19.05 g/g

  • SCr: 0.94 mg/dl

  • ALB: 2.2 g/dl

DPGN, IgAN (M0E1S1T0C1)High-dose steroid

  • PR.

  • UPCR was 6 g/g within 4 weeks.

 17Schaubschlager4435/FUSAIgAN, psoriasis

  • SCr: 1.0 mg/dl,

  • UPCR: 0.36 g/g

mRNA (Pfizer)

  • D79 after

  • 2nd dose

SRPUPCR: 2 g/gSCr: 1.1 mg/dlIgAN (M1E1S1T0C1)High-dose steroid + immunosuppressive

  • R.

  • UPCR was 1.14 g/g within 4 weeks.

a

Prednisone was initiated for the treatment of pericarditis.

COVID-19, coronavirus disease 2019; IgAN, IgA nephropathy; F, female; M, male; GH, gross hematuria; SRP, sub-nephrotic range proteinuria; NRP, nephrotic range proteinuria; SCr, serum creatinine; ANA, anti-nuclear antibody; C3, complement C3; CRP, C-reactive protein; ALB, serum albumin; RBC, red blood cell; WBC, white blood cell; HPF, high power field; UPCR, urine protein-to-creatinine ratio; UACR, urinary albumin-creatinine ratio; ACR, microalbumin-creatinine ratio; UTP, 24-h urine protein; CR, complete remission; PR, partial remission; NA, non-applicable; NR, no response; R, response; KT, kidney transplantation; HD, hemodialysis; RASi, renin–angiotensin–aldosterone system inhibition; ABPC, ampicillin; SBT, sulbactam; HTN, hypertension; T1DM, type 1 diabetes mellitus; AIN, acute interstitial nephritis; DPGN, diffuse proliferative glomerulonephritis; APS, antiphospholipid syndrome; GDM, gestational diabetes; AAN, aristolochic acid nephropathy; RF, renal failure; NS, nephrotic syndrome; AKI, acute tubular injury; GERD, gastroesophageal reflux disease; CKD, chronic kidney disease; MEST-C, M = mesangial hypercellularity, E = endocapillary proliferation, S = segmental glomerulosclerosis, T = tubular atrophy/interstitial fibrosis, C = crescents.

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