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Review
. 2024 Feb;13(1):53-58.
doi: 10.1007/s13730-023-00798-3. Epub 2023 May 27.

Relapse of minimal change disease following the third mRNA COVID-19 vaccination: a case report and literature review

Mariko Teragaki  1 , Mari Tanaka  2 , Hiroko Yamamoto  2 , Tomoka Watanabe  2 , Jun Takeoka  2 , Awaisshafig Fukumi  2 , Kotaro Maeda  2 , Yohtaro Takami  2 , Hirona Saita  2 , Sachio Iwanari  2 , Masaki Ikeda  2 , Hiroya Takeoka  2
Affiliations
Review

Relapse of minimal change disease following the third mRNA COVID-19 vaccination: a case report and literature review

Mariko Teragaki et al. CEN Case Rep. 2024 Feb.

Abstract

Mass vaccination is the most important strategy to terminate the coronavirus disease 2019 (COVID-19) pandemic. Reports suggest the potential risk of the development of new-onset or relapse of minimal change disease (MCD) following COVID-19 vaccination; however, details on vaccine-associated MCD remain unclear. A 43-year-old man with MCD, who had been in remission for 29 years, developed nephrotic syndrome 4 days after receiving the third dose of the Pfizer-BioNTech vaccine. His kidney biopsy revealed relapsing MCD. Intravenous methylprednisolone pulse therapy followed by oral prednisolone therapy was administered, and his proteinuria resolved within 3 weeks. This report highlights the importance of careful monitoring of proteinuria after COVID-19 vaccination in patients with MCD, even if the disease is stable and no adverse events occurred during previous vaccinations. Our case report and literature review of COVID-19 vaccine-associated MCD indicated that MCD relapse tends to occur later after vaccination and slightly more often following the second and subsequent vaccine doses than new-onset MCD.

Keywords: BNT162 vaccine; COVID-19 vaccine booster shot; Nephrotic syndrome; Recurrence; mRNA vaccines.

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Conflict of interest statement

All the authors have declared no competing interest.

Figures

Fig. 1
Fig. 1
Kidney biopsy findings. Light microscopy of representative glomerulus stained by a periodic acid–methenamine silver (original magnification, × 100) and b periodic acid–Schiff (original magnification, × 400), demonstrating minor glomerular abnormality. Hyalinosis of an arteriole is observed (arrow). c, d Electron microscopy reveals diffuse podocyte effacement without electron–dense deposits (original magnification, × 1500 and × 6000, respectively)
See this image and copyright information in PMC

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