Glomerulonephritis with Positive Anti-Glomerular Basement Membrane Antibodies following COVID-19 Vaccine.

PRESENTATION: A 78 year old female presented to the emergency department with a one day history of haemoptysis, cough, fever and shortness of breath. This was two days after the second dose of her Covid-19 mRNA vaccine.

DIAGNOSIS: A diagnosis of vaccine-mediated anti-glomerular basement membrane antibody (anti-GBM) disease (or Goodpasture's Syndrome) was made after a vasculitic screen was sent for suspected glomerulonephritis.

TREATMENT: She was treated with IV Methylprednisolone 1000mg IV for three days, seven sequential sessions of plasmapheresis and pulsed IV Cyclophosphamide, with resolution of haemoptysis and kidney function.

DISCUSSION: It is important to maintain a high index of suspicion and test for anti-GBM disease in patients receiving SARS-CoV-2 mRNA vaccination.