Idiopathic nephrotic syndrome relapse following COVID-19 vaccination: a series of 25 cases - Centre de Recherche en Transplantation et Immunologie
Article Dans Une Revue Clinical Kidney Journal Année : 2022

Idiopathic nephrotic syndrome relapse following COVID-19 vaccination: a series of 25 cases

1 Service Néphrologie et transplantation rénale Adultes [CHU Necker]
2 IMRB - Institut Mondor de Recherche Biomédicale
3 ICMPE - Institut de Chimie et des Matériaux Paris-Est
4 U955 Inserm - UPEC - IMRB - "Transfusion et Maladies du Globule Rouge" [Créteil]
5 U1064 Inserm - CR2TI - Centre de Recherche en Transplantation et Immunologie - Center for Research in Transplantation and Translational Immunology
6 ITERT - Institut de Transplantation et de Recherche en Transplantation [CHU Nantes]
7 Hôpital Necker - Enfants Malades [AP-HP]
8 Service de Néphrologie [Rouen]
9 EnVI - Endothélium, valvulopathies et insuffisance cardiaque
10 Association ECHO [Expansion des Centres d’Hémodialyse de l’Ouest]
11 Service Néphrologie, Hémodialyses [CHU Clermont-Ferrand]
12 Centre hospitalier Saint Joseph - Saint Luc [Lyon]
13 Centre Hospitalier de Roubaix
14 Service Néphrologie, médecine interne et hypertension pédiatrique [CHU Toulouse]
15 CHI André Gregoire - Centre Hospitalier Intercommunal André Grégoire [Montreuil]
16 IREC - Institut de Recherche Expérimentale et Clinique
17 Cliniques Universitaires Saint-Luc [Bruxelles]
18 Faculté de Médecine et Médecine Dentaire [UCLouvain]
19 UNISI - Università degli Studi di Siena = University of Siena
20 Vilnius University [Vilnius]
21 Hôpital Lapeyronie [CHU Montpellier]
22 Service de néphrologie, rhumatologie et dermatologie pédiatriques [Hôpital Femme Mère Enfant, HCL]
23 HFME - Hôpital Femme Mère Enfant [CHU - HCL]
24 Hôpital Henri Mondor
Andrea Guarnieri
  • Fonction : Auteur
Andrea Angeletti
  • Fonction : Auteur
Guillaume Goussard
  • Fonction : Auteur
Laurent Hudier
  • Fonction : Auteur
Aude Servais
  • Fonction : Auteur

Résumé

Background: Several cases of idiopathic nephrotic syndrome (INS) relapse following the administration of coronavirus disease 2019 (COVID-19) vaccines have recently been reported, raising questions about the potential relationship between the immune response to COVID-19 vaccination and INS pathogenesis. Methods: We performed a retrospective multicentre survey describing the clinical and biological characteristics of patients presenting a relapse of INS after COVID-19 vaccination, with an assessment of outcome under treatment. Results: We identified 25 patients (16 men and 9 women) presenting a relapse within 1 month of a COVID-19 vaccine injection. The glomerular disease was of childhood onset in half of the patients and most patients (21/25) had received at least one immunosuppressive drug in addition to steroids for frequently relapsing or steroid-dependent nephrotic syndrome (NS). All patients were in a stable condition at the time of injection and 11 had no specific treatment. In five patients, the last relapse was reported >5 years before vaccine injection. The Pfizer-BioNTech (BNT162b2) vaccine was used in 80% of the patients. In 18 cases, INS relapse occurred after the first injection, a mean of 17.5 days after vaccination. A second injection was nevertheless administered in 14 of these patients. Five relapses occurred after administration of the second dose and two relapses after the administration of the third dose. All but one of the patients received steroids as first-line treatment, with an additional immunosuppressive agent in nine cases. During follow-up, complete remission was achieved in 21 patients, within 1 month in 17 cases. Only one patient had not achieved at least partial remission after 3 months of follow-up. Conclusions: This case series suggests that, in rare patients, COVID-19 vaccination may trigger INS relapse that is generally easy to control. These findings should encourage physicians to persuade their patients to complete the COVID-19 vaccination schedule
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hal-04696807 , version 1 (13-09-2024)

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Aurélie Hummel, Julie Oniszczuk, Delphine Kervella, Marina Charbit, Dominique Guerrot, et al.. Idiopathic nephrotic syndrome relapse following COVID-19 vaccination: a series of 25 cases. Clinical Kidney Journal, 2022, 15 (8), pp.1574 - 1582. ⟨10.1093/ckj/sfac134⟩. ⟨hal-04696807⟩
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