PDF(Pubmed)
Abstract：
The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been followed by many reports of the development and relapse of autoimmune diseases associated with SARS-CoV-2 vaccination. Some of these reports have involved relapse or onset of immunoglobulin A (IgA) nephropathy following SARS-CoV-2 vaccination. Here, we report on a patient with IgA nephropathy who presented with gross hematuria and rapidly progressive glomerulonephritis following SARS-CoV-2 vaccination.
A 63-year-old male patient with a history of habitual tonsillitis underwent bilateral tonsillectomy. He had a history of alcoholic cirrhosis of the liver and microscopic hematuria and proteinuria were indicated during a health checkup 2 years before hospital admission. He developed hematuria after the SARS-CoV-2 vaccination, which led to rapidly progressive glomerulonephritis, for which he was hospitalized. A renal biopsy led to the diagnosis of IgA nephropathy. Although pulse steroid therapy during his condition resulted in hepatic encephalopathy, three courses combined with mizoribine improved his renal function.
SARS-CoV-2 mRNA vaccines activate T cells, which are involved in the pathophysiology of IgA nephropathy. Therefore, this case suggests that the exacerbation of IgA nephropathy by the vaccine favors the vasculitis aspect of the disease.
A 63-year-old male patient with a history of habitual tonsillitis underwent bilateral tonsillectomy. He had a history of alcoholic cirrhosis of the liver and microscopic hematuria and proteinuria were indicated during a health checkup 2 years before hospital admission. He developed hematuria after the SARS-CoV-2 vaccination, which led to rapidly progressive glomerulonephritis, for which he was hospitalized. A renal biopsy led to the diagnosis of IgA nephropathy. Although pulse steroid therapy during his condition resulted in hepatic encephalopathy, three courses combined with mizoribine improved his renal function.
SARS-CoV-2 mRNA vaccines activate T cells, which are involved in the pathophysiology of IgA nephropathy. Therefore, this case suggests that the exacerbation of IgA nephropathy by the vaccine favors the vasculitis aspect of the disease.
摘要：
背景：严重急性呼吸道综合征冠状病毒2（SARS-CoV-2）感染的爆发之后，已经有许多与SARS-CoV-2疫苗接种相关的自身免疫性疾病的发展和复发的报道。其中一些报道涉及SARS-CoV-2疫苗接种后免疫球蛋白A（IgA）肾病的复发或发作。这里,我们报道了1例IgA肾病患者在接种SARS-CoV-2疫苗后出现肉眼血尿和快速进展性肾小球肾炎.
方法：一名有习惯性扁桃体炎病史的63岁男性患者接受了双侧扁桃体切除术。他有酒精性肝硬化病史，入院前2年的健康检查中发现镜下血尿和蛋白尿。他在SARS-CoV-2疫苗接种后出现血尿,导致快速进展性肾小球肾炎，为此他住院了。肾活检导致IgA肾病的诊断。尽管在他的病情期间进行脉冲类固醇治疗会导致肝性脑病，三个疗程联合咪唑立宾改善了他的肾功能。
结论：SARS-CoV-2mRNA疫苗激活T细胞，这与IgA肾病的病理生理学有关。因此,这种情况表明疫苗对IgA肾病的加重有利于该疾病的血管炎方面。
方法：一名有习惯性扁桃体炎病史的63岁男性患者接受了双侧扁桃体切除术。他有酒精性肝硬化病史，入院前2年的健康检查中发现镜下血尿和蛋白尿。他在SARS-CoV-2疫苗接种后出现血尿,导致快速进展性肾小球肾炎，为此他住院了。肾活检导致IgA肾病的诊断。尽管在他的病情期间进行脉冲类固醇治疗会导致肝性脑病，三个疗程联合咪唑立宾改善了他的肾功能。
结论：SARS-CoV-2mRNA疫苗激活T细胞，这与IgA肾病的病理生理学有关。因此,这种情况表明疫苗对IgA肾病的加重有利于该疾病的血管炎方面。
