An Unusual Glomerulopathy with Subepithelial Deposits Having Microspherular Structures Following COVID-19 Vaccine

Abstract

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.