Clin Transplant Res.  2025 Mar;39(1):66-70. 10.4285/ctr.24.0027.

Enlarged lymph node occupying the retroperitoneal space and psoas muscle causes ureteric compression and graft kidney hydronephrosis after COVID-19 mRNA vaccine booster: a case report

• Kim DH
• Ryu TH
• Kim HY
• Ahn JM
• Oh JS
• Kim JK

• KMID: 2566581
• DOI: http://doi.org/10.4285/ctr.24.0027

Abstract

Vaccine-induced hypermetabolic lymph nodes have been clinically observed following coronavirus disease 2019 (COVID-19) mRNA vaccination. Specifically, the booster dose of the mRNA vaccines, produced by Pfizer and Moderna, has been linked to a relatively high incidence of lymphadenopathy. We present the case of a kidney transplant recipient who developed an enlarged abdominal mass after receiving a booster dose of the COVID-19 mRNA vaccine. This mass occupied the retroperitoneal space, infiltrated the psoas muscle, and resulted in ureteric compression and hydronephrosis. Percutaneous drainage and analysis of the perirenal fluid revealed the presence of lymphatic fluid. In summary, lymphadenopathy is a recognized adverse reaction to the Pfizer and Moderna vaccines. Patients with compromised immune systems should be informed about the incidence and potential severity of lymphadenopathy following booster vaccination.

Keyword

COVID-19; Vaccine; Kidney; Transplant recipient; Lymphadenopathy

Figure

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  Fig. 1 (A) Computed tomography images displaying perirenal fluid collection around the transplanted kidney (arrows), and (B) within the psoas muscle (arrow), as well as (C) pleural effusion in the left lower lung field (arrow).

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  Fig. 2 Two months following the administration of the mRNA coronavirus disease 2019 (COVID-19) booster, (A) computed tomography revealed a reduction in fluid accumulation around the transplanted kidney (arrow), and (B) within the psoas muscle (arrow), with no evidence of ureteric compression or hydronephrosis.

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