Acute interstitial nephritis following SARS-CoV-2 vaccination
Abstract
We read with interest the recent publication by Czerlau et al. [1] on a series of patients with acute interstitial nephritis (AIN) following severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) vaccination.We have recently reported a similar case and noted a further case by de la Flor et al. [2, 3]. Unver et al. [4] reported a case of AIN with concurrent nephrotic syndrome after SARS-CoV-2 vaccination. Here, we would like to report two additional cases. The first patient is a 69-year-old female patient with rheumatoid arthritis, Sjøgren’s syndrome, hypertension and hypothyroidism who presented with polyuria 5 days after the first dose of the Oxford-AstraZeneca SARS-CoV-2 (ChAdOx1 nCoV-19) vaccine. Regular medications included methotrexate, folic acid, ramipril, thyroxine and paroxetine, as well as lansoprazole on an ‘as required’ basis, although the patient did not take any in the last month. The physical examination was unremarkable. Blood tests revealed acute kidney injury (AKI) with an increased serum creatinine at 245 μmol/L (baseline is 85 μmol/L). The only other abnormality noted was peripheral eosinophilia. Urine dipstick did not show proteinuria or haematuria. Renal ultrasound and immunology screen were both normal. The patient was started on intravenous fluids, with ramipril and methotrexate being discontinued. Renal biopsy showed a florid interstitial infiltrate with eosinophils, with no glomerular abnormalities and no chronic interstitial damage. The…
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