Immunofluorescence findings were available for 24 cases

Immunofluorescence findings were available for 24 cases. describing their clinical manifestations and treatment response of this emerging entity. Supplementary Information The online version contains supplementary material available at 10.1007/s00296-021-05069-x. the development of autoimmune diseases in healthy individuals underwent inadequate scrutiny. Drawing a Chitinase-IN-1 parallel to COVID-19 infection, researchers worldwide cast doubt over the immunogenicity of the vaccines, with an exaggerated immune response similar to an SARS-CoV-2 infection [9]. Antigen presentation, cytokine profiling, bystander activation, epitope spreading, anti-idiotypic networks, polyclonal activation of B cells are all the mechanisms that may theoretically contribute to this exaggerated immune response [9]. A growing number of reports describe the onset and recurrence of glomerular diseases Chitinase-IN-1 like anti-Glomerular Basement Membrane (anti-GBM) disease and AAV with the widespread use of the vaccines [10]. Mainly, these occurred in individuals Chitinase-IN-1 who were susceptible to autoimmune diseases and those in remission with these disorders. Therefore, an accepted hypothesis is that AAV develops in patients with a susceptible genetic background and a simultaneous Rabbit Polyclonal to BORG2 exposure to environmental or other risk factors [11]. Previously, numerous reports have described a temporal association of AAV to influenza vaccination [12]. The aforementioned observations strengthen our credence that the SARS-CoV-2 vaccine could induce an autoimmune response analogous to the infection/influenza vaccine as causality for AAV. Furthermore, with the recent evidence suggesting booster doses of COVID-19 vaccines besides the typical dosing (in the vulnerable populace) [13], it is pertinent to study the association of autoimmune diseases with COVID-19 vaccination comprehensively. Consequently, we present a 51-year-old gentleman developing a new-onset AAV following a ChAdOx1 nCoV19 SARS-CoV-2 vaccine having a case-based review of the literature of similar instances. Case statement A 51-year-old gentleman with no prior comorbidity (serum creatinine 1.2?mg/dl, before his illness) presented with a 3-day time history of low-grade fever with debilitating inflammatory polyarthritis. He was a non-smoker and did not have any related complaints in the past. He (or his contacts) experienced no history of COVID-19 illness. He received the 1st dose of ChAdOx1 nCoV-19 Vaccine (COVISHIELD- manufactured by Serum Institute of India Pvt Ltd.) 15?days before the onset of present symptoms. However, for synovitis including multiple bones, his physical exam was unremarkable. On investigating, he had deranged kidney functions (serum creatinine- 4.8?mg/dl), proteinuria (3.4?g/day time) and microscopic haematuria (erythrocyte casts and 8C10 erythrocytes/high-power field), elevated inflammatory markers (erythrocyte sedimentation rate (ESR)46?mm/hour and C-reactive protein7?mg/L) and PR-3 ANCA positivity. Anti-Nuclear Antibody (ANA), double-stranded DNA antibody (dsDNA), anti-GBM antibody titres were bad, and serum match levels were within normal limits. The blood and the urine cultures were bad. Kidney biopsy Chitinase-IN-1 suggested pauci-immune crescentic glomerulonephritis (Supplemental Number 1). Nineteen out of the 20 glomeruli biopsied showed crescents with predominant cellular crescents. Having a analysis of PR3-AAV, he was referred to our hospital, and we started him on oral prednisolone (60?mg/day time) Chitinase-IN-1 and rituximab (375?mg/m2 weekly for 4 weeks). We tapered oral prednisolone as per the low-dose steroid tapering routine of the PEXIVAS trial [14]. At 20 weeks of follow-up, he had total resolution of his constitutional symptoms and arthralgias, serum creatinine (2.3?mg/dl) and proteinuria (1.0?g/day time) showing a steady decrease, and micro-haematuria subsided. Search strategy and case selection We carried out a case-based search in PubMed, with the following search?(COVID-19 vaccine OR COVID-19 OR COVID-19 vaccination OR SARS-CoV-2 vaccine OR SARS-CoV-2 OR Oxford AstraZeneca OR Moderna OR Pfizer-BioNTech OR Sputnik OR Sinopharm OR BBV152/Covaxin OR Janssen OR CoronaVac OR Novavax) AND (ANCA OR ANCA related Glomerulonephritis OR ANCA-associated glomerulonephritis OR ANCA Associated Vasculitis OR Glomerulonephritis OR MPO ANCA OR PR-3 ANCA OR Pauci-immune glomerulonephritis OR De novo vasculitis OR Anti-Neutrophil cytoplasmic antibody OR Antineutrophil cytoplasmic antibody OR Myeloperoxidase OR Anti-proteinase-3) from?1st January 2020 to 15th November 2021.?We included.