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辉瑞 COVID-19 疫苗接种后微小病变病的再激活。

Reactivation of minimal change disease after Pfizer vaccine against COVID-19.

机构信息

Resident, Rowan School of Osteopathic Medicine Internal Medicine Residency, Stratford, NJ, USA.

Resident, Jefferson Health New Jersey Internal Medicine Residency, Stratford, NJ, USA.

出版信息

J Osteopath Med. 2022 Jun 15;122(10):499-501. doi: 10.1515/jom-2022-0064. eCollection 2022 Oct 1.

Abstract

This case follows a 54-year-old woman with a medical history of hypertension who experienced reactivation of minimal change disease (MCD) after receiving the Pfizer vaccine against COVID-19. She had her first episode of MCD 15 days after receiving the influenza vaccine in 2018. She remained in remission for over 3 years following treatment with steroids. She experienced foamy urine and leg edema after receiving the first dose of the Pfizer vaccine, but she did not consult medical professionals until she received the second dose. She wanted to be fully vaccinated because she worked in healthcare. Her initial diagnosis of MCD in 2018 was made following a kidney biopsy. The diagnosis of reactivation following COVID-19 vaccine was made with labs and presenting symptoms. At presentation, her urine protein was 9,977 mg/day. She was treated with prednisone 50 mg/day following her relapse with improvement in her urine protein to 85 mg/g within 4 weeks of starting treatment. She is currently undergoing treatment with prednisone with improvement in her presenting symptoms, which included foaming of urine and edema of legs. This case demonstrates the importance of vigilance in patients with a history of MCD when receiving the COVID-19 vaccine, particularly if they have a history of such reactions to other vaccines. Patients should discuss the benefits and risks of receiving the vaccine with their medical professionals and stay cognizant about the possibility of reactivation after receiving the COVID-19 vaccine.

摘要

本病例报告了一位 54 岁的女性,她有高血压病史,在接种辉瑞公司的 COVID-19 疫苗后,出现微小病变病(MCD)复发。她在 2018 年接种流感疫苗后 15 天首次出现 MCD。在接受类固醇治疗后,她已经缓解了 3 年多。她在接种辉瑞疫苗第一剂后出现泡沫尿和腿部水肿,但直到接种第二剂后才咨询医务人员。她想完全接种疫苗,因为她在医疗保健行业工作。她在 2018 年首次诊断为 MCD 是通过肾活检做出的。COVID-19 疫苗接种后 MCD 复发的诊断是通过实验室检查和临床表现做出的。就诊时,她的尿蛋白为 9977mg/天。她在复发后接受泼尼松 50mg/天治疗,在开始治疗的 4 周内,尿蛋白改善至 85mg/g。她目前正在接受泼尼松治疗,其临床表现有所改善,包括泡沫尿和腿部水肿。本病例表明,对于有 MCD 病史的患者,在接种 COVID-19 疫苗时应保持警惕,特别是如果他们有过其他疫苗类似反应的病史。患者应与医务人员讨论接种疫苗的益处和风险,并注意接种 COVID-19 疫苗后可能出现的复发。

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