Tang Xiaoxiao, Liu Fei, Li Qiuyu, Fu Haidong, Wang Jingjing, Mao Jianhua
Department of Nephrology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, National Children's Regional Medical Center, Hangzhou, China.
Curr Rheumatol Rev. 2023;19(2):151-158. doi: 10.2174/1573397118666220817092235.
The coronavirus disease 2019 (COVID-19) pandemic continues to spread around the world. Vaccinations have been administered globally and have been proven to be safe and effective. However, vasculitis has been reported as an adverse event occurring after COVID-19 vaccination.
In this review, we analyzed the literature to identify original articles that reported on patients who developed vasculitis following COVID-19 vaccination and summarized their clinical manifestations. PubMed and Web of Knowledge were searched to identify relevant studies.
A total of 27 patients who developed vasculitis following COVID-19 vaccination were identified from 21 studies. The involved organs included the skin and kidney. The main clinical features of patients whose skin was affected were papules, maculopapular rashes, and plaques. Most of the patients exhibited small vessel vasculitis and single-organ vasculitis; these were resolved within one month. Patients whose kidneys were affected exhibited vasculitis, including anti-neutrophil cytoplasmic antibody glomerulonephritis and IgA nephritis. Most patients were treated with corticosteroid, rituximab, and cyclophosphamide, and one patient needed hemodialysis. The renal function of most patients was improved or recovered, but one patient needed maintenance dialysis.
Vasculitis was rarely reported after COVID-19 vaccine administration. It often manifested as cutaneous small-vessel vasculitis or glomerulonephritis. Notably, when a patient demonstrates hematuria, proteinuria, and acute kidney injury after COVID-19 vaccination, there is a possibility that the patient could have developed vasculitis. Skin-related problems were quickly resolved, while kidney-related problems may progress to chronic kidney disease.
2019年冠状病毒病(COVID-19)大流行在全球持续蔓延。疫苗已在全球范围内接种,并已被证明是安全有效的。然而,血管炎已被报告为COVID-19疫苗接种后的不良事件。
在本综述中,我们分析文献以确定报告COVID-19疫苗接种后发生血管炎患者的原始文章,并总结其临床表现。检索了PubMed和Web of Knowledge以识别相关研究。
从21项研究中确定了27例COVID-19疫苗接种后发生血管炎的患者。受累器官包括皮肤和肾脏。皮肤受累患者的主要临床特征为丘疹、斑丘疹和斑块。大多数患者表现为小血管血管炎和单器官血管炎;这些在1个月内得到缓解。肾脏受累患者表现为血管炎,包括抗中性粒细胞胞浆抗体肾小球肾炎和IgA肾病。大多数患者接受了皮质类固醇、利妥昔单抗和环磷酰胺治疗,1例患者需要血液透析。大多数患者的肾功能得到改善或恢复,但1例患者需要维持透析。
COVID-19疫苗接种后血管炎的报告很少。它常表现为皮肤小血管血管炎或肾小球肾炎。值得注意的是,当患者在COVID-19疫苗接种后出现血尿、蛋白尿和急性肾损伤时,有可能发生了血管炎。皮肤相关问题迅速得到解决,而肾脏相关问题可能进展为慢性肾脏病。