PMID- 35462990
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220429
IS  - 2296-858X (Print)
IS  - 2296-858X (Electronic)
IS  - 2296-858X (Linking)
VI  - 9
DP  - 2022
TI  - Development of Alveolar Hemorrhage After Pfizer-BioNTech COVID-19 mRNA 
      Vaccination in a Patient With Renal-Limited Anti-neutrophil Cytoplasmic 
      Antibody-Associated Vasculitis: A Case Report.
PG  - 874831
LID - 10.3389/fmed.2022.874831 [doi]
LID - 874831
AB  - Since the coronavirus disease 2019 (COVID-19) pandemic continues and a new 
      variant of the virus has emerged, the COVID-19 vaccination campaign has 
      progressed. Rare but severe adverse outcomes of COVID-19 vaccination such as 
      anaphylaxis and myocarditis have begun to be noticed. Of note, several cases of 
      new-onset antineutrophil cytoplasmic antibody-associated vasculitis (AAV) after 
      COVID-19 mRNA vaccination have been reported. However, relapse of AAV in 
      remission has not been recognized enough as an adverse outcome of COVID-19 
      vaccination. We report, to our knowledge, a first case of renal-limited AAV in 
      remission using every 6-month rituximab administration that relapsed with 
      pulmonary hemorrhage, but not glomerulonephritis, following the first dose of the 
      Pfizer-BioNTech COVID-19 vaccine. The patient received the COVID-19 vaccine more 
      than 6 months after the last dose of rituximab according to the recommendations. 
      However, his CD19(+) B cell counts were found to be increased after admission, 
      indicating that our case might have been prone to relapse after COVID-19 
      vaccination. Although our case cannot establish causality between AAV relapse and 
      COVID-19 mRNA vaccination, a high level of clinical vigilance for relapse of AAV 
      especially in patients undergoing rituximab maintenance therapy following 
      COVID-19 vaccination should be maintained. Furthermore, elapsed time between 
      rituximab administration and COVID-19 mRNA vaccination should be carefully 
      adjusted based on AAV disease-activity.
CI  - Copyright (c) 2022 Nishioka, Yamaguchi, Yasuda, Yoshimoto, Kojima, Kaneko, Aso, 
      Nagasaka, Yoshida, Uchiyama, Tajima, Yoshino, Yoshida, Kanda and Itoh.
FAU - Nishioka, Ken
AU  - Nishioka K
AD  - Division of Endocrinology, Metabolism and Nephrology, Department of Internal 
      Medicine, Tokyo, Japan.
FAU - Yamaguchi, Shintaro
AU  - Yamaguchi S
AD  - Division of Endocrinology, Metabolism and Nephrology, Department of Internal 
      Medicine, Tokyo, Japan.
FAU - Yasuda, Itaru
AU  - Yasuda I
AD  - Division of Endocrinology, Metabolism and Nephrology, Department of Internal 
      Medicine, Tokyo, Japan.
FAU - Yoshimoto, Norifumi
AU  - Yoshimoto N
AD  - Division of Endocrinology, Metabolism and Nephrology, Department of Internal 
      Medicine, Tokyo, Japan.
FAU - Kojima, Daiki
AU  - Kojima D
AD  - Division of Endocrinology, Metabolism and Nephrology, Department of Internal 
      Medicine, Tokyo, Japan.
FAU - Kaneko, Kenji
AU  - Kaneko K
AD  - Division of Endocrinology, Metabolism and Nephrology, Department of Internal 
      Medicine, Tokyo, Japan.
FAU - Aso, Mitsuhiro
AU  - Aso M
AD  - Division of Endocrinology, Metabolism and Nephrology, Department of Internal 
      Medicine, Tokyo, Japan.
FAU - Nagasaka, Tomoki
AU  - Nagasaka T
AD  - Division of Endocrinology, Metabolism and Nephrology, Department of Internal 
      Medicine, Tokyo, Japan.
FAU - Yoshida, Eriko
AU  - Yoshida E
AD  - Division of Endocrinology, Metabolism and Nephrology, Department of Internal 
      Medicine, Tokyo, Japan.
FAU - Uchiyama, Kiyotaka
AU  - Uchiyama K
AD  - Division of Endocrinology, Metabolism and Nephrology, Department of Internal 
      Medicine, Tokyo, Japan.
FAU - Tajima, Takaya
AU  - Tajima T
AD  - Division of Endocrinology, Metabolism and Nephrology, Department of Internal 
      Medicine, Tokyo, Japan.
FAU - Yoshino, Jun
AU  - Yoshino J
AD  - Division of Endocrinology, Metabolism and Nephrology, Department of Internal 
      Medicine, Tokyo, Japan.
FAU - Yoshida, Tadashi
AU  - Yoshida T
AD  - Apheresis and Dialysis Center, Keio University School of Medicine, Tokyo, Japan.
FAU - Kanda, Takeshi
AU  - Kanda T
AD  - Division of Endocrinology, Metabolism and Nephrology, Department of Internal 
      Medicine, Tokyo, Japan.
FAU - Itoh, Hiroshi
AU  - Itoh H
AD  - Division of Endocrinology, Metabolism and Nephrology, Department of Internal 
      Medicine, Tokyo, Japan.
LA  - eng
PT  - Case Reports
DEP - 20220408
PL  - Switzerland
TA  - Front Med (Lausanne)
JT  - Frontiers in medicine
JID - 101648047
PMC - PMC9023855
OTO - NOTNLM
OT  - COVID-19 mRNA vaccination
OT  - alveolar hemorrhage
OT  - relapse
OT  - renal-limited ANCA-associated vasculitis
OT  - rituximab
COIS- The authors declare that the research was conducted in the absence of any 
      commercial or financial relationships that could be construed as a potential 
      conflict of interest.
EDAT- 2022/04/26 06:00
MHDA- 2022/04/26 06:01
PMCR- 2022/04/08
CRDT- 2022/04/25 05:15
PHST- 2022/02/13 00:00 [received]
PHST- 2022/03/16 00:00 [accepted]
PHST- 2022/04/25 05:15 [entrez]
PHST- 2022/04/26 06:00 [pubmed]
PHST- 2022/04/26 06:01 [medline]
PHST- 2022/04/08 00:00 [pmc-release]
AID - 10.3389/fmed.2022.874831 [doi]
PST - epublish
SO  - Front Med (Lausanne). 2022 Apr 8;9:874831. doi: 10.3389/fmed.2022.874831. 
      eCollection 2022.