Background The COVID-19 pandemic has led to widespread vaccination with effective results and a great safety profile. However, as the vaccination rate has increased, more cases of autoimmune diseases after the COVID-19 vaccine have been described. We present a systematic review of ANCA-associated glomerulonephritis after the COVID-19 vaccine.

Objectives To summarize the existing evidence on ANCA-associated glomerulonephritis after the COVID-19 vaccine.

Methods We searched all studies from inception till January 27, 2022, that described ANCA-associated biopsy-proven glomerulonephritis after COVID-19 vaccine through Embase and Medline. Methodological quality was evaluated with the 4 domains tool. We included 13 patients from 2 case series and 9 case reports. We extracted demographics, history, lab results, outcomes. We then applied descriptive statistics.

Results 46% of the patients were males and 54% were females. The median age was 74 years. 54% developed symptoms after the second dose of the 2-dose vaccine. The median interval between the vaccine and the symptom onset was 10.5 days. 85% had anti-MPO antibodies, and the rest – anti-PR3 antibodies. 31% of patients had persistent creatinine (Cr) elevation on follow-up, and 3 patients were requiring hemodialysis. Of those 3 patients, 1 patient had normal renal function prior to presentation, and the rest had chronic kidney disease. The summary of the cases is presented in Table 1.

Conclusion Although the causality cannot be established on current evidence, the COVID-19 vaccine can probably trigger glomerulonephritis associated with ANCA, primarily anti-MPO type. We need a bigger cohort to identify patients predisposed for disease development or relapse after the COVID-19 vaccine.

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Disclosure of Interests None declared