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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Before the biologic era, when rheumatoid arthritis (RA) activity was difficult to control, IgA nephropathy (IgAN) was not an uncommon complication of RA. However, with advances in treatment strategies using biologics and Janus kinase inhibitors, IgAN has become a rare renal complication in RA patients. Here, we report three cases of new-onset IgAN following COVID-19 mRNA vaccination in patients with long-term, well-controlled RA receiving biologic therapy.
This study describes three patients who developed newly diagnosed IgAN following COVID-19 mRNA vaccination during the clinical course of well-controlled RA. The first patient developed microscopic hematuria and proteinuria after the third dose of a COVID-19 mRNA vaccine, and renal biopsy confirmed IgAN. Switching biologics from abatacept to an interleukin-6 (IL-6) inhibitor resulted in resolution of urinary abnormalities. The second patient developed microscopic hematuria and proteinuria one month after the fourth COVID-19 vaccination, and proteinuria increased to 4.24g/gCr three days after the fifth dose. Renal biopsy revealed IgAN. Although switching biologics from a TNF-α inhibitor to an IL-6 inhibitor was only partially effective, short-term glucocorticoid administration led to partial improvement in proteinuria. The third patient, whose RA was well-controlled with methotrexate and a TNF-α inhibitor, developed macroscopic hematuria approximately eight weeks after the fifth dose of the COVID-19 vaccine. Her renal function gradually deteriorated, and urinary protein excretion increased. Renal biopsy revealed IgAN with cellular or fibrocellular crescents in 23% of glomeruli. Methylprednisolone pulse therapy followed by glucocorticoid maintenance therapy led to complete resolution of proteinuria and full recovery of renal function, allowing successful discontinuation of glucocorticoid therapy.
All patients developed IgAN after COVID-19 mRNA vaccination. Urinary abnormalities resolved after switching biologics from abatacept or a TNF-α inhibitor to an IL-6 inhibitor, with or without short-term glucocorticoid co-administration or methylprednisolone pulse therapy. Complete resolution of urinary abnormalities in two of the three patients without maintenance glucocorticoid or immunosuppressant therapy suggests that COVID-19 mRNA vaccination may induce self-limiting immune stimulation in patients with RA. Because elevated IL-6 levels in RA are thought to promote mesangial cell proliferation, RA patients may have a potential risk of developing IgAN after COVID-19 mRNA vaccination.
The near-complete disappearance of urinary abnormalities even after discontinuation of glucocorticoid therapy supports a possible link between COVID-19 vaccination and the development of IgAN in patients with RA.
