Jha Vijoy Kumar, Akal Ramanjit Singh, Sharma Alok, Mahapatra Debasish
Department of Nephrology, Command Hospital Air Force, Bengaluru, Karnataka, India.
Renal Pathology and Electron Microscopy, Chief Renal Pathologist, Lal Path Labs Ltd, New Delhi, India.
Indian J Nephrol. 2022 Jul-Aug;32(4):378-383. doi: 10.4103/ijn.ijn_23_22. Epub 2022 Jul 16.
With the ongoing mass COVID vaccination program, various case reports link the COVID-19 vaccines with heightened off-target immune responses leading to de novo development or relapse of various glomerular diseases. Very few glomerular diseases (totally nine published cases to date) have been reported post ChAdOx1 nCoV-19 (Oxford-AstraZeneca) vaccination compared to more potent m RNA vaccine. In this case report, we present a case of de novo focal segmental glomerulosclerosis (FSGS) post ChAdOx1 nCoV-19 vaccination resistant to steroid and calcineurin inhibitor treatment. To our knowledge, this is the first case of FSGS tip variant reported after the ChAdOx1 nCoV-19 vaccination and the second de novo FSGS case post COVID vaccination (any types of COVID vaccines). We may expect more such types of cases resistant to conventional therapy as the global penetration of vaccination programs will improve.
随着大规模新冠疫苗接种计划的持续推进，各种病例报告将新冠疫苗与增强的脱靶免疫反应联系起来，这些反应导致各种肾小球疾病的新发或复发。与效力更强的mRNA疫苗相比，接种ChAdOx1 nCoV-19（牛津-阿斯利康）疫苗后报告的肾小球疾病非常少（迄今为止总共9例已发表病例）。在本病例报告中，我们展示了1例接种ChAdOx1 nCoV-19疫苗后发生的新发局灶节段性肾小球硬化（FSGS）病例，该病例对类固醇和钙调神经磷酸酶抑制剂治疗耐药。据我们所知，这是ChAdOx1 nCoV-19疫苗接种后报告的首例FSGS顶端变异型病例，也是新冠疫苗接种后（任何类型的新冠疫苗）的第二例新发FSGS病例。随着疫苗接种计划在全球的普及，我们可能会看到更多此类对传统治疗耐药的病例。
