Christodoulou Michalis, Iatridi Fotini, Chalkidis George, Lioulios Georgios, Nikolaidou Christina, Badis Kostas, Fylaktou Asimina, Papagianni Aikaterini, Stangou Maria
Department of Nephrology, Hippokration Hospital, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
Department of Pathology, Hippokration Hospital, 54642 Thessaloniki, Greece.
Life (Basel). 2022 Jul 18;12(7):1072. doi: 10.3390/life12071072.
In the last two years, our world experienced one of the most devastating and fast-exploding pandemic, due to the wide spread of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The scientific community managed to develop effective vaccines, the main weapons to shield the immune system and protect people. Nevertheless, both SARS-CoV-2 infection and the vaccination against it have been associated with the stimulation of inflammatory cells such as T and B lymphocytes that results in a cytokine storm, endothelial inflammation and vascular injury, which can lead to different types of vasculitis. We present the first case of de novo MPO-ANCA-associated vasculitis, which developed shortly after SARS-CoV-2 vaccination, adequately responded to treatment, and subsequently relapsed after COVID-19 infection. With this case, we indicate an etiological connection between viral infection and disease development, as well as the possibility of a common immune mechanism between SARS-CoV-2 infection and vaccination, that can stimulate vascular events and lead to vasculitis. There have been several case reports of de novo vasculitis, affecting large, medium, or small vessels, following either infection or vaccination against COVID-19, during the pandemic outbreak. We summarize previous reports and also analyze proposed pathogenic mechanisms between SARS-CoV-2 and vasculitis.
在过去两年中，由于严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的广泛传播，我们的世界经历了一场最具破坏性且迅速蔓延的大流行。科学界成功研发出了有效的疫苗，这是保护免疫系统和人们的主要武器。然而，SARS-CoV-2感染及其疫苗接种都与T和B淋巴细胞等炎症细胞的刺激有关，这会引发细胞因子风暴、内皮炎症和血管损伤，进而导致不同类型的血管炎。我们报告了首例接种SARS-CoV-2疫苗后不久出现的新发髓过氧化物酶抗中性粒细胞胞浆抗体（MPO-ANCA）相关血管炎病例，该病例对治疗反应良好，但在感染新冠病毒后复发。通过这个病例，我们指出了病毒感染与疾病发展之间的病因学联系，以及SARS-CoV-2感染与疫苗接种之间存在共同免疫机制的可能性，这种机制可刺激血管事件并导致血管炎。在大流行期间，已有多例关于感染新冠病毒或接种新冠疫苗后出现新发血管炎的病例报告，累及大、中或小血管。我们总结了先前的报告，并分析了SARS-CoV-2与血管炎之间可能的致病机制。
