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We report an unusual glomerulopathy with nephrotic syndrome and acute kidney injury almost two weeks after the second injection of SARS CoV-2 vaccine covishield, ChAdOx1-nCoV-19 in a 75-year-old healthy man. Kidney biopsy revealed segmental stage 1 membranous glomerulopathy and collapsing focal segmental glomerulosclerosis pattern with immune complexes on IF. Electron microscopy (EM) revealed aggregates of spherular microparticles along glomerular capillary walls. After starting him on steroids, his kidney functions gradually improved with significantly reduced proteinuria. Our patient seems to be the only reported SARS CoV-2 vaccine-induced early membranous nephropathy showing a collapsing focal segmental glomerulosclerosis pattern and immune complexes on IF with subepithelial deposits consisting of microspherular particles on EM.
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http://dx.doi.org/10.25259/ijn_465_23 | DOI Listing |
Indian J Nephrol
July 2024
Department of Pathology, Government Medical College Srinagar, Jammu Kashmir, India.
We report an unusual glomerulopathy with nephrotic syndrome and acute kidney injury almost two weeks after the second injection of SARS CoV-2 vaccine covishield, ChAdOx1-nCoV-19 in a 75-year-old healthy man. Kidney biopsy revealed segmental stage 1 membranous glomerulopathy and collapsing focal segmental glomerulosclerosis pattern with immune complexes on IF. Electron microscopy (EM) revealed aggregates of spherular microparticles along glomerular capillary walls.
View Article and Find Full Text PDFReports (MDPI)
August 2025
Department of Nephrology, Hospital Central Defense Gomez Ulla, 28047 Madrid, Spain.
Membranoproliferative glomerulonephritis (MPGN) is a rare and heterogeneous pattern of immune-mediated glomerular injury, often associated with infections, autoimmune disorders, or monoclonal gammopathies. Idiopathic cases remain a diagnostic challenge and frequently require empirical immunosuppressive treatment. There is increasing interest in environmental triggers that may activate the immune system in genetically or immunologically predisposed individuals.
View Article and Find Full Text PDFGlomerular Dis
April 2025
Department of Pathology, Duke University Medical Center, Durham, NC, USA.
Background: Renal pathologists face a number of challenges in evaluating kidney biopsies: one that is sometimes overlooked is the presence of multiple pathological processes in a single biopsy. Figuring out the interrelatedness (or lack thereof) of more than one form of renal abnormality can difficult. Several pitfalls in biopsy evaluation also await the unprepared diagnostician.
View Article and Find Full Text PDFNephrology (Carlton)
May 2025
Department of Pathology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India.
Podocyte infolding glomerulopathy is a rare pathological entity characterised by invagination of the podocyte cell membrane into the glomerular basement membrane with presence of microspheres and/or microtubules on electron microscopy. Without an ultrastructure study, it is often confused with and misdiagnosed as membranous nephropathy. The pathogenesis of this disease remains unclear and the majority of cases show association with connective tissue disorders.
View Article and Find Full Text PDFIndian J Nephrol
July 2024
Department of Nephrology, Christian Medical College, Vellore, Tamil Nadu, India.
The simultaneous occurrence of vasculitic glomerulonephritis and membranous nephropathy is unusual. We report two cases that presented to our outpatient department with rapidly progressive renal failure. On evaluation, in one patient, anti-myeloperoxidase (MPO) titers were high, and renal biopsy was suggestive of concurrent necrotizing and diffuse crescentic anti-MPO anti-neutrophil cytoplasmic antigen-associated glomerulonephritis with the circumferential cellular crescent formation and membranous glomerulopathy.
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