{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T12:59:40Z","timestamp":1780059580048,"version":"3.54.0"},"reference-count":20,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>mRNA\u2010based COVID\u201019 vaccines have been associated with rare renal complications, including podocytopathies. We report a 72\u2010year\u2010old Japanese man with a 32\u2010year history of type 2 diabetes and an 11\u2010year history of stable membranous nephropathy (MN) who developed nephrotic syndrome (NS) after receiving his third dose of the BNT162b2 mRNA vaccine. His proteinuria, which had been stable at approximately 0.5\u2009g\/gCr for years, acutely increased to 14.3\u2009g\/gCr. A kidney biopsy revealed diffuse thickening of the glomerular basement membrane with subepithelial spike formation, and phospholipid A2 receptor (PLA2R)\u2010positive deposits embedded in the membrane (Churg stage 2\u20134), consistent with his chronic, inactive MN. However, several clinical features were atypical for an MN relapse: serum anti\u2010PLA2R antibodies were undetectable, the protein selectivity index was low (indicating highly selective proteinuria), and a transient spontaneous reduction in proteinuria occurred during hospitalisation. Although early\u2010stage gastric cancer was concurrently detected and curatively resected via endoscopic submucosal dissection, NS recurred shortly thereafter. Proteinuria rapidly decreased to baseline levels following steroid pulse therapy\u2014a therapeutic response characteristic of minimal change disease (MCD). Based on these findings, we diagnosed the patient with vaccine\u2010associated MCD superimposed on stable MN. This case suggests that when an existing glomerular disease follows an unusually acute course after vaccination, clinicians should consider the possibility of a superimposed podocytopathy. Accurate differentiation is essential, as the management of MCD differs significantly from that of MN.<\/jats:p>","DOI":"10.1111\/nep.70209","type":"journal-article","created":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:17:18Z","timestamp":1777375038000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["A Case of Minimal Change Disease Superimposed on Stable Membranous Nephropathy Following the Third Dose of\n                    <scp>COVID<\/scp>\n                    \u201019\n                    <scp>mRNA<\/scp>\n                    Vaccine in a Patient With Type 2 Diabetes"],"prefix":"10.1111","volume":"31","author":[{"given":"Takeo","family":"Koshida","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Department of Nephrology Juntendo University  Tokyo 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