Focal Segmental Glomerulosclerosis after COVID-19 Vaccine: A Case Report and Literature Review

Introduction: We present a case of de novo focal segmental glomerulosclerosis (FSGS) occurring approximately two months after receiving the Moderna COVID-19 vaccine. Case Description: A 77-year-old man with no personal or family history of kidney disease was admitted with dizziness, anasarca and acute kidney injury. On Admission, blood pressure was high (150/86 mmHg) and lab tests showed elevated serum creatinine (Cr) (1.8 mg/dl with normal baseline Cr), low albumin (2.3 g/dl), and significant proteinuria (urine-protein-to-creatinine ratio of 13.37 g/g). Kidney biopsy revealed complete effacement of podocytes and early-stage FSGS (Figure 1 A&B). Detailed history and workups were negative except for report of receiving Moderna COVID-19 vaccine approximately two months prior. Treatment with prednisone (60 mg/day) was started, leading to complete resolution of proteinuria, normalization of Cr levels and overall symptoms (Figure 1 C&D). Discussion: This case highlights the significance of maintaining a high level of clinical suspicion for FSGS as a potential complication of COVID-19 vaccines (Table 1). Further studies are still needed to establish causality.