Nephrology Center, Toranomon Hospital, Japan.
Department of Human Pathology, Tokyo Medical and Dental University, Japan.
Intern Med. 2023 Apr 1;62(7):1077-1080. doi: 10.2169/internalmedicine.9410-22. Epub 2022 Sep 6.
A 66-year-old man was admitted to our hospital because of a low-grade fever and arthralgia. The symptoms started on the third day after influenza vaccine administration and persisted for two months. Serum creatinine was 1.0 mg/dL; C-reactive protein, 16.1 mg/dL; and myeloperoxidase antineutrophil cytoplasmic antibodies (MPO-ANCA), 4,170 IU/mL. A kidney biopsy showed crescentic glomerulonephritis with fibrinoid necrosis of small arteries. Microscopic polyangiitis was diagnosed. After five months of steroid pulse therapy and rituximab administration, the patient entered remission. There have been very few reports of this condition after influenza vaccine administration.
一位 66 岁男性因低热和关节痛入住我院。症状始于流感疫苗接种后第 3 天,持续了 2 个月。血清肌酐 1.0mg/dL;C 反应蛋白 16.1mg/dL;髓过氧化物酶抗中性粒细胞胞质抗体(MPO-ANCA)4170IU/mL。肾活检显示新月体性肾小球肾炎伴小动脉纤维蛋白样坏死。诊断为显微镜下多血管炎。经过 5 个月的类固醇脉冲治疗和利妥昔单抗治疗后,患者进入缓解期。该患者在接种流感疫苗后出现这种情况的报道非常少。