Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to spread around the world. As of the end of June 2021, there were approximately 181 million confirmed cases and more than 3.9 million deaths across the globe. The colossal impact of coronavirus disease 2019 (COVID-19) is driving the biggest vaccination campaign in human history. All 3 vaccines authorized for emergency use by the US Food and Drug Administration (Pfizer-BioNTech, Moderna, and Janssen/Johnson & Johnson) have been thoroughly studied and found to be safe and effective in preventing severe COVID-19 cases. While short-term side effects of COVID-19 vaccine resemble those of other vaccines, long-term side effects remain unknown. Rare side effects continue to surface as millions of people receive COVID-19 vaccines around the world, as compared with the thousands enrolled in the clinical trials. We report a case of new-onset renal-limited ANCA-associated vasculitis (AAV) in a 78-year-old woman with previously normal kidney function after receiving the Pfizer-BioNTech COVID-19 vaccine. The patient developed acute kidney injury with proteinuria and microscopic hematuria with many dysmorphic red blood cells in the urine. Anti-myeloperoxidase antibody titer was elevated. Kidney biopsy showed pauci-immune crescentic necrotizing glomerulonephritis. Kidney function improved after treatment with steroids and rituximab. Our patient had normal routine laboratory testing before the vaccination. Although this case cannot demonstrate a causal relationship between COVID-19 vaccination and AAV, ongoing surveillance for similar complications would be prudent as worldwide vaccination efforts continue.

严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 继续在世界范围内传播。截至 2021 年 6 月底，全球约有 1.81 亿确诊病例和超过 390 万人死亡。2019 年冠状病毒病 (COVID-19) 的巨大影响正在推动人类历史上最大的疫苗接种运动。美国食品和药物管理局（Pfizer-BioNTech、Moderna 和 Janssen/Johnson & Johnson）授权紧急使用的所有 3 种疫苗都经过彻底研究，发现在预防严重的 COVID-19 病例方面是安全有效的。虽然 COVID-19 疫苗的短期副作用与其他疫苗相似，但长期副作用仍然未知。随着全球数百万人接种 COVID-19 疫苗，罕见的副作用继续浮出水面，与参加临床试验的数千人相比。我们报告了一名 78 岁女性在接受辉瑞-BioNTech COVID-19 疫苗后肾功能正常的新发肾限制性 ANCA 相关血管炎 (AAV) 病例。患者出现急性肾损伤，伴有蛋白尿和镜下血尿，尿液中有许多畸形红细胞。抗髓过氧化物酶抗体滴度升高。肾活检显示寡免疫性新月体坏死性肾小球肾炎。用类固醇和利妥昔单抗治疗后肾功能得到改善。我们的患者在接种疫苗前进行了正常的常规实验室检查。尽管此案例无法证明 COVID-19 疫苗接种与 AAV 之间存在因果关系，