Acute Granulomatous Interstitial Nephritis Post-COVID-19 Vaccination
Bibliographic record
Abstract
Introduction: Various kidney diseases were described with association to Vaccination. In this case, we have identifed a patient with acute granulomatous interstitial nephritis likely associated with Moderna Covid-19 vaccine. Case Description: 56 year old Caucasian male with history of dyslipidemia, erectile dysfunction and alopecia was seen with new onset renal failure discovered Jan. 2023 3 months post Covid-19 vaccination. He had 4 doses overall and last dose was given in Oct. 2022. His eGFR was 70cc/min in Feb 2022 before plummeting to 8cc per min in Jan. 2023, which prompted referral. Renal biopsy was done Jan. 2023 and showed acute granulomatous interstitial nephritis. Serological work up were negative. Differentials: sarcoidosis ( chest CT neg),TB, fungal infection (culture neg) , pauci-immune glomerulonephrritis and drug (finasteride) induced reaction was considered unlikely. On Jan.25, 2023 he was started high dose prednisone treatment 60 mg per day and tapered down about 5 mg per week. And his eGFR started to improve to 40cc/min. Second renal biopsy showed disappearance of granulomatas lesion.Upon stopping prednisone, his eGFR started to drop again to 20 cc per min. He had third renal biopsy which showed recurrence of multiple large non-necrotizing granulomas lesion involving most of the sampled renal tissue. There are very prominent eosinophils as well. He responded again to prednisone and was switched to and maintained on cellcept.Althought the course is somewhat atypical, association with Moderna vaccination is more likely than other causes. Since May 2024 he has been on Cellcept 1 g bid with fairly good response eGFR went up to 38 cc/min. Discussion: Previous studies have shown association between Covid Vaccination and acute interstitial nephritis. We have shown in this abstract a case with AIN and non-necrotizing granulomatas lesion. As reported previously, there is a reasonable response to large dose steroids followed by Cellcept.Diffuse acute granulomas intersitial nephritis H&E stain. 200x
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".