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新冠病毒疫苗作为抗肾小球基底膜(GBM)疾病的潜在触发因素:一例病例报告及文献综述

COVID-19 Vaccine as a Potential Triggering Factor for Anti-Glomerular Basement Membrane (GBM) Disease: A Case Report and Literature Review.

作者信息

Ahmed Mohanad, Mohamed Sabah, Alhussein Hussein, Eltazi Isra, Sibira Rayan M, Abdulhadi Ahmad

机构信息

Rheumatology, Hamad General Hospital, Doha, QAT.

Internal Medicine, Hamad General Hospital, Doha, QAT.

出版信息

Cureus. 2022 Sep 12;14(9):e29075. doi: 10.7759/cureus.29075. eCollection 2022 Sep.

Abstract

Coronavirus 2019 (COVID-19) is considered one of the most significant medical pandemics of this century, with high morbidity and mortality associated with the pandemic. The virus was recognized initially as a cause of pneumonia, but subsequent studies showed significant association with gastrointestinal, neurological, and autoimmune diseases. By 2020, several vaccines became available for use, significantly reducing the infection rate. A good safety profile supported most of the studies related to vaccines. However, this area is still under study, and some reports linked the COVID-19 vaccine to the development of thrombocytopenia, thrombosis, Guillain-Barre syndrome, autoimmune diseases, and myocarditis. These side effects need to be reported to VAERS (Vaccine Adverse Event Reporting System). The exact etiology of anti-glomerular basement (Anti-GBM) disease remains unknown, but the disease is thought to be triggered by environmental factors in genetically predisposed individuals. It is considered one of the serious diseases that could lead to permanent kidney impairment if not treated early and adequately. That's why a great effort is being made by health care practitioners to figure out and avoid the risk and triggering factors. Few previously published papers linked the COVID-19 vaccine and the development of anti-GBM disease, which raised concerns about digging more into this area. Herein, we are reporting a case of a patient who developed rapidly progressive glomerulonephritis (RPGN) due to anti-glomerular basement membrane (GBM) antibody disease two days after receiving the second dose of the COVID-19 vaccine.

摘要

2019冠状病毒病(COVID-19)被认为是本世纪最严重的医学大流行之一,该大流行伴随着高发病率和死亡率。该病毒最初被认为是肺炎的病因,但随后的研究表明它与胃肠道、神经和自身免疫性疾病有显著关联。到2020年,几种疫苗可供使用,显著降低了感染率。大多数与疫苗相关的研究都支持其良好的安全性。然而,这一领域仍在研究中,一些报告将COVID-19疫苗与血小板减少症、血栓形成、吉兰-巴雷综合征、自身免疫性疾病和心肌炎的发生联系起来。这些副作用需要向疫苗不良事件报告系统(VAERS)报告。抗肾小球基底膜(Anti-GBM)病的确切病因尚不清楚,但该病被认为是由遗传易感性个体中的环境因素引发的。如果不及早并充分治疗,它被认为是可能导致永久性肾脏损害的严重疾病之一。这就是医疗从业者正在努力找出并避免风险和触发因素的原因。此前很少有发表的论文将COVID-19疫苗与抗GBM病的发生联系起来,这引发了对该领域进行更多深入研究的担忧。在此,我们报告一例患者,在接种第二剂COVID-19疫苗两天后,因抗肾小球基底膜(GBM)抗体病发展为快速进展性肾小球肾炎(RPGN)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c38/9559358/48069874d2f0/cureus-0014-00000029075-i01.jpg

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