Received Jul 1, 2026
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| COVID19 | COVID19 (COVID19 (MODERNA)) | MODERNA | 1 | — | — |
Contactin-1-Associated Membranous Nephropathy; transient neuropathic sensation in one heel; This literature-non-study case was reported in a literature article and describes the occurrence of GLOMERULONEPHRITIS MEMBRANOUS (Contactin-1-Associated Membranous Nephropathy) and NEUROPATHY PERIPHERAL (transient neuropathic sensation in one heel) in a 79-year-old male patient who received SPIKEVAX NOS (SPIKEVAX NOS) for COVID-19 vaccination. LITERATURE REFERENCE: Concurrent medical conditions included Hypertension (30-year history), Diabetes (30-year history), Coronary artery disease (30-year history) and Thyroid disorder NOS. Concomitant products included Dapagliflozin propanediol monohydrate (Dapagliflozin), Dulaglutide, Metformin hydrochloride (Metformin) and Glipizide for Diabetes, Levothyroxine sodium (Levothyroxine) for Thyroid disorder NOS, Telmisartan, Nebivolol hydrochloride (Nebivolol), Ezetimibe, Atorvastatin calcium (Atorvastatin) and Evolocumab for Vascular disorder NOS. On an unknown date, the patient received fifth dose of SPIKEVAX NOS (SPIKEVAX NOS) (unknown route) 1 dosage form. On an unknown date, received fourth dose of SPIKEVAX NOS (SPIKEVAX NOS) (unknown route) dosage was changed to 1 dosage form, third dose of SPIKEVAX NOS (SPIKEVAX NOS) (unknown route) dosage was changed to 1 dosage form, second dose of SPIKEVAX NOS (SPIKEVAX NOS) (unknown route) dosage was changed to 1 dosage form and first dose of SPIKEVAX NOS (SPIKEVAX NOS) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced GLOMERULONEPHRITIS MEMBRANOUS (Contactin-1-Associated Membranous Nephropathy) (seriousness criterion medically significant) and NEUROPATHY PERIPHERAL (transient neuropathic sensation in one heel) (seriousness criterion medically significant). At the time of the report, GLOMERULONEPHRITIS MEMBRANOUS (Contactin-1-Associated Membranous Nephropathy) and NEUROPATHY PERIPHERAL (transient neuropathic sensation in one heel) had resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Antineutrophil cytoplasmic antibody: (Negative) serology. On an unknown date, Antinuclear antibody: (Negative) serology. On an unknown date, Biopsy kidney: The specimen contained renal cortex with 33 glomeruli (3 globally sclerotic). Glomerular capillary loops exhibited a heterogenous texture with intra-membranous lucencies and vague spikes. There was focal minimal mesangial hypercellularity. There were no endocapillary hypercellularity, segmental sclerosis, necrotizing lesions, nor crescents. There was mild interstitial fibrosis/tubular atrophy in 10% of the cortex and moderate arteriosclerosis. On an unknown date, Blood albumin: 4.2 g/dL at time zero. On an unknown date, Blood creatinine: 0.93 mg/dl at 0 time, 1.05 mg/dl at 3 months and 1.15 mg/dl at 12 months. On an unknown date, Chest X-ray: Negative. On an unknown date, Colonoscopy: Negative. On an unknown date, Computerised tomogram abdomen: Negative. On an unknown date, Electrophoresis protein: (Negative) Serum electrophoresis negative for monoclonal proteins. On an unknown date, Endoscopy upper gastrointestinal tract: (Negative) EGD. On an unknown date, Genetic testing: (Negative) A genetic panel for kidney disease was negative. On an unknown date, Hepatitis B surface antigen: (Negative) Serology/ Testing infection. On an unknown date, Hepatitis C virus test: (Negative) Serology/ Testing infection. On an unknown date, Immunoassay: (Negative) negative for monoclonal proteins and studies demonstrated diffuse global granular capillary wall staining for IgG (2+) and both light chains (trace each). Staining for IgM, C1q, and C3 was negative. Immunofluorescence microscopy demonstrates global granular glomerular capillary wall staining with IgG. On an unknown date, Immunoelectrophoresis: (Negative) reference range: not provided. On an unknown date, Immunohistochemistry: (Negative) PLA2R, NELL-1, THSD7A, and EXT-2 immunohistochemical stains were negative. A diagnosis of membranous nephropathy, stage 2 of 4 was rendered. On an unknown date, Microscopy: studies demonstrated numerous subepithelial deposits associated with spike-like basement membrane remodeling and diffusely effaced podocyte foot processes. Extremely rare small deposits were present in subendothelial and mesangial regions. No features of diabetic nephropathy were present. Tubuloreticular inclusions were absent and demonstrates tiny intra- membranous lucencies within glomerular capillary walls. On an unknown date, Physical examination: on examination, he moved all four extremities with equal strength, walked steadily, and did not have neurologic deficits evident to the examining physician. On an unknown date, Prostatic specific antigen: (Negative) 0.72 ng/mL/negative for malignancy.. On an unknown date, Protein urine: 2888 mg per 24 hours of proteinuria at 0 time, 2112 mg per 24 hours at 3 months post-biopsy, 2066 mg per 24 hours at 6 months post-biopsy and 203 mg per 24 hours at 18 months post-biopsy. On an unknown date, Syphilis test: (Negative) Serology/ Testing infection. On an unknown date, Urine analysis: hematuria (2+ on dipstick and 13 red blood cells/high power field on urinalysis). On an unknown date, Urine electrophoresis: (Negative) negative for monoclonal proteins. For SPIKEVAX NOS (SPIKEVAX NOS) (Unknown), the reporter considered GLOMERULONEPHRITIS MEMBRANOUS (Contactin-1-Associated Membranous Nephropathy) to be related. No further causality assessment was provided for NEUROPATHY PERIPHERAL (transient neuropathic sensation in one heel). Patient presented with ankle edema and soapy appearing urine. His serum creatinine was stable and ranged from 0.93 to 1.1 mg/dL. Patient had previously received five doses of COVID-19 vaccination with mRNA 1273 at 19, 18, 10, 3, and 1 month prior to symptom onset. The patient presented to a nephrology clinic for evaluation of proteinuria and initially did not note symptoms of neuropathy or muscle weakness. EMG/NCS and further neurologic evaluation were not ordered. In retrospect, upon learning of the association of contactin-1 with chronic inflammatory demyelinating polyneuropathy, the patient recalled transient neuropathic sensation in one heel. There were no other signs or symptoms of neuropathy. A diagnosis of membranous nephropathy, stage 2 of 4 was rendered. Mass spectrometry for 13 antigens associated with membranous nephropathy was performed and identified the presence of contactin-1. The patient was maintained on the medication regimen with no other specific therapy for membranous nephropathy being initiated. He had no additional COVID vaccinations. The patient's proteinuria and edema subsequently resolved over the next 18 months. In this case, the spontaneous resolution of the membranous nephropathy in the absence of any disease-specific therapy, the temporal association with recent vaccination, and the relatively early histologic features of membranous nephropathy on biopsy generate the hypothesis that vaccination was a potential explanation in this case. This case report thus broadens the pathologic spectrum of membranous nephropathy cases due to this antigenic target. To the authors knowledge, this was the first case report demonstrating a temporal association between contactin-1-associated membranous nephropathy and vaccination against COVID- 19 with mRNA 1273. Future understanding of this phenomenon might identify thresholds of anti-spike protein antibodies beyond which this intermolecular epitope spreading was likely to occur.; Reporter's Comments: Glomerulonephritis membranous and Neuropathy peripheral are confounded by advanced age and comorbid conditions including long-standing hypertension and diabetes mellitus. The benefit-risk relationship of the product is not affected by this report.
Coronary artery disease (30-year history); Diabetes (30-year history); Hypertension (30-year history); Thyroid disorder NOS
Telmisartan; Nebivolol; Dapagliflozin; Ezetimibe; Atorvastatin; Evolocumab; Dulaglutide; Metformin; Glipizide; Levothyroxine
Test Name: anti-neutrophil cytoplasmic antibodies (ANCA); Test Result: Negative ; Test Name: antinuclear antibodies (ANA); Test Result: Negative ; Test Name: kidney biopsy; Result Unstructured Data: The specimen contained renal cortex with 33 glomeruli (3 globally sclerotic). Glomerular capillary loops exhibited a heterogenous texture with intra-membranous lucencies and vague spikes. There was focal minimal mesangial hypercellularity. There were no endocapillary hypercellularity, segmental sclerosis, necrotizing lesions, nor crescents. There was mild interstitial fibrosis/tubular atrophy in 10% of the cortex and moderate arteriosclerosis; Test Name: Serum albumin; Result Unstructured Data: 4.2 g/dL at time zero; Test Name: Creatinine/serum creatinine; Test Result: 0.93 mg/dL; Test Name: Creatinine/serum creatinine; Test Result: 1.05 mg/dL; Test Name: Creatinine/serum creatinine; Test Result: 1.15 mg/dL; Test Name: chest X-ray; Test Result: Negative ; Test Name: colonoscopy; Test Result: Negative ; Test Name: CT abdomen/pelvis; Test Result: Negative ; Test Name: Serum electrophoresis/ Protein electrophoresis; Test Result: Negative ; Test Name: upper endoscopy; Test Result: Negative ; Test Name: genetic panel for kidney disease; Test Result: Negative ; Test Name: Hepatitis B s Ag; Test Result: Negative ; Test Name: hepatitis C; Test Result: Negative ; Test Name: immunofixation; Test Result: Negative ; Test Name: Immunofluorescence; Result Unstructured Data: studies demonstrated diffuse global granular capillary wall staining for IgG (2+) and both light chains (trace each). Staining for IgM, C1q, and C3 was negative. Immunofluorescence microscopy demonstrates global granular glomerular capillary wall staining with IgG; Test Name: Immunoelectrophoresis; Test Result: Negative ; Test Name: immunohistochemical stains; Test Result: Negative ; Test Name: Electron Microscopy; Result Unstructured Data: studies demonstrated numerous subepithelial deposits associated with spike-like basement membrane remodeling and diffusely effaced podocyte foot processes. Extremely rare small deposits were present in subendothelial and mesangial regions. No features of diabetic nephropathy were present. Tubuloreticular inclusions were absent; Test Name: Light microscopy; Result Unstructured Data: demonstrates tiny intra- membranous lucencies within glomerular capillary walls; Test Name: examination; Result Unstructured Data: on examination, he moved all four extremities with equal strength, walked steadily, and did not have neurologic deficits evident to the examining physician; Test Name: PSA/prostate-specific antigen; Test Result: Negative ; Test Name: Urine protein; Result Unstructured Data: 2888 mg per 24 hours of proteinuria at 0 time; Test Name: Urine protein; Result Unstructured Data: 2112 mg per 24 hours at 3 months post-biopsy; Test Name: Urine protein; Result Unstructured Data: 2066 mg per 24 hours at 6 months post-biopsy; Test Name: Urine protein; Result Unstructured Data: 203 mg per 24 hours at 18 months post-biopsy; Test Name: RPR; Test Result: Negative ; Test Name: urinalysis; Result Unstructured Data: hematuria (2+ on dipstick and 13 red blood cells/high power field on urinalysis); Test Name: urine electrophoresis; Test Result: Negative