New-onset lupus nephritis and neuropsychiatric lupus following COVID-19 vaccination: A case report.

Although COVID-19 mRNA vaccines have demonstrated excellent safety profiles, rare autoimmune complications - including new-onset systemic lupus erythematosus (SLE) and lupus nephritis (LN) - have been reported. We describe a case of new-onset class IV LN with neuropsychiatric lupus (NPSLE) occurring shortly after COVID-19 vaccination in a previously healthy adult. This case highlights a rare presentation of new-onset SLE manifesting with both severe renal and neuropsychiatric involvement following COVID-19 mRNA vaccination. While causality cannot be established, the temporal association and absence of alternative triggers suggest vaccine-induced immune dysregulation as a potential precipitating factor. Awareness of such atypical presentations may facilitate earlier diagnosis and management, although these events remain exceedingly uncommon relative to the overwhelming benefits of vaccination.