mRNA-1273 COVID-19 vaccine

  • 文章类型: Case Reports
    随着COVID-19mRNA疫苗的广泛使用,据报道,接受COVID-19疫苗接种后新发肾小球疾病的病例。这里,我们介绍了一例接受mRNA-1273(Moderna)COVID-19疫苗接种后经肾活检证实的新发IgA血管炎.一名47岁的男性,有10年高血压和高尿酸血症病史,在接受初始mRNA-1273COVID-19疫苗注射治疗腿部和足背部紫癜性皮疹19天后到我院就诊。尽管喷发在5天内自发改善,他们在第二次注射后15天再次发展。皮肤活检标本的组织病理学检查让人想起白细胞碎裂性血管炎,尽管直接免疫荧光没有表明IgA在小血管壁内沉积。尿液分析提示重度蛋白尿(3+)和隐血(3+)。因此,进行了肾脏活检,光学显微镜显示轻度肾小球系膜扩张,细胞过多,和毛细血管内细胞增多,在三个和一个中观察到细胞和纤维细胞的新月体,分别,总共15个肾小球。免疫荧光还显示IgA的弥漫性颗粒肾小球系膜染色(3+)。组织病理学特征与IgA血管炎一致。开始静脉注射甲基强的松龙1000mg,持续3天,然后口服泼尼松龙(0.6mg/kg/天)。在接下来的两周内,血清肌酐水平从1.24提高到1.06mg/dL,蛋白尿从2.98降低到0.36g/gCr,尽管隐血持续存在。本案的研究结果表明,接受mRNA-1273COVID-19疫苗后的新发IgA血管炎可以用皮质类固醇治疗。
    As mRNA COVID-19 vaccines have become widely available, cases of new-onset glomerular disease after receiving COVID-19 vaccination have been reported. Here, we present a case of kidney biopsy-proven new-onset IgA vasculitis after receiving the mRNA-1273 (Moderna) COVID-19 vaccination. A 47-year-old man with a 10-year medical history of hypertension and hyperuricemia visited our hospital 19 days after receiving an initial mRNA-1273 COVID-19 vaccine injection for purpuric eruption on the legs and dorsal regions of the feet. Although the eruptions spontaneously improved within 5 days, they developed again at 15 days after the second injection. A histopathological examination of skin biopsy specimens was reminiscent of leukocytoclastic vasculitis, though direct immunofluorescence did not indicate IgA deposition within small vessel walls. Urinalysis indicated severe proteinuria (3 +) and occult blood (3 +). Thus, a kidney biopsy was performed and light microscopy revealed mild mesangial expansion, hypercellularity, and endocapillary hypercellularity, with cellular and fibrocellular crescents observed in three and one, respectively, of a total of 15 glomeruli. Immunofluorescence also showed diffuse granular mesangial staining (3 +) for IgA. Histopathological features were consistent with IgA vasculitis. Intravenous methylprednisolone at 1000 mg for 3 days was initiated, followed by oral prednisolone (0.6 mg/kg/day). Over the following 2-week period, serum creatinine level improved from 1.24 to 1.06 mg/dL and proteinuria decreased from 2.98 to 0.36 g/g Cr, though occult blood persisted. Findings in the present case indicate that new-onset IgA vasculitis after receiving mRNA-1273 COVID-19 vaccine can be treated with corticosteroid therapy.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

公众号