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Case Reports
. 2024 Jan 8;12(1):62.
doi: 10.3390/vaccines12010062.

Tip Lesion Most Frequent FSGS Variant Related to COVID-19 Vaccine: Two Case Reports and Literature Review

Emmy Marjorie Carvalho de Araújo  1 , Marcos Adriano Garcia Campos  2 , Andressa Monteiro Sodré  1 , Maria Izabel de Holanda  3 , Rodrigo Hagemann  4 , Antonio Augusto Lima Teixeira Júnior  5 , Natalino Salgado Filho  1 , Precil Diego Miranda de Menezes Neves  6 , Gyl Eanes Barros Silva  1   7
Affiliations
Case Reports

Tip Lesion Most Frequent FSGS Variant Related to COVID-19 Vaccine: Two Case Reports and Literature Review

Emmy Marjorie Carvalho de Araújo et al. Vaccines (Basel). .

Abstract

Large-scale COVID-19 vaccination has been one of the most effective strategies to control the spread of the SARS-CoV-2 virus. However, several cases of glomerular injury related to the COVID-19 vaccine have been described in the literature. We report two cases of a tip lesion variant of focal segmental glomerulosclerosis (FSGS), which presented with significant proteinuria and improved after immunosuppression. In our literature review, the tip lesion variant of FSGS is currently the most frequent variant associated with vaccination against COVID-19. Prognosis is favorable and without significant alterations in the tubulointerstitial or vascular compartments. Adverse effects of vaccines need to be recognized early and will help us to understand the immune and pathological mechanisms of kidney damage.

Keywords: COVID-19; SARS-CoV-2; focal segmental glomerulosclerosis; kidney biopsy; vaccine.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Histopathological findings in renal biopsy. (A) Glomerulus with segmental sclerosis at the tubular pole (black arrow) surrounded by normal tubulointerstitial compartment. (B) Segmental sclerosis with adherence and herniated into the tubular lumen (black arrow). (C) Normal glomerulus in the same patient (black arrow indicating vascular pole). (A–C) Masson’s trichrome stain. (D,E) C3 and IgM deposits in tubular pole observed via immunofluorescence (white arrow). (F) Electron microscopy showing diffuse podocytes foot process effacement (black arrow) and microvillous transformation (black head arrow).
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