Nakazawa Eriko, Uchimura Toru, Hirai Yuji, Togashi Hayato, Oyama Yoshitaka, Inaba Aya, Shiga Kentaro, Ito Shuichi
Department of Pediatrics, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan.
Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Kanagawa, Japan.
CEN Case Rep. 2022 May;11(2):242-246. doi: 10.1007/s13730-021-00656-0. Epub 2021 Nov 15.
Various new vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been rapidly developed. The new onset and recurrence of nephrotic syndrome triggered by some vaccines have been documented and several adult cases of minimal change nephrotic syndrome newly developing after SARS-CoV-2 vaccination have been reported. However, no reports of pediatric cases have been published. Indications for SARS-CoV-2 vaccines have been expanded to those as young as 12 years old and vaccination of children has just started in Japan. We encountered a 15-year-old boy without underlying disease who newly developed nephrotic syndrome after SARS-CoV-2 vaccination with BNT162b2 (Pfizer-BioNTech). He developed eyelid edema 4 days after vaccination and peripheral edema of the lower extremities a further 4 days later. Twenty-one days after vaccination, 60 mg of oral daily prednisolone was started. He achieved complete remission in 12 days without complications such as hypertension or acute kidney injury. We clinicians should be aware of the possibility of nephrotic syndrome developing after SARS-CoV-2 vaccination, not only in adults, but also in children.
针对严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的多种新型疫苗已迅速研发出来。一些疫苗引发的肾病综合征的新发和复发已有文献记载,并且已有数例成人在接种SARS-CoV-2疫苗后新出现微小病变型肾病综合征的病例报告。然而,尚无儿科病例的报道。SARS-CoV-2疫苗的适用人群已扩大至12岁及以上,日本刚刚开始为儿童接种疫苗。我们遇到一名15岁无基础疾病的男孩,在接种辉瑞-BioNTech的BNT162b2型SARS-CoV-2疫苗后新出现了肾病综合征。他在接种疫苗4天后出现眼睑水肿,又过了4天出现下肢外周水肿。接种疫苗21天后,开始每日口服60毫克泼尼松龙。他在12天内实现完全缓解,未出现高血压或急性肾损伤等并发症。我们临床医生不仅应意识到成人,也应意识到儿童在接种SARS-CoV-2疫苗后可能发生肾病综合征。