Annicchiarico Petruzzelli Luigi, Minale Bruno, Serio Vittorio, De Luca Angela, Marino Marsilia Giuseppina, Campione Severo, Diomedi Camassei Francesca, D'Arcangelo Rosamunda, Luongo Ilaria, Lepore Lorenza, Giannattasio Paolo, Molino Daniela, Pirro Laura, Lonardo Maria Concetta, Malgieri Gabriele, Pecoraro Carmine
Paediatric Nephrology, Dialysis and Renal Transplantation Santobono Pausilipon Children's Hospital, Naples, Italy.
Section of Pathology, Antonio Cardarelli Hospital, Naples, Italy.
G Ital Nefrol. 2022 Dec 21;39(6):2022-vol6.
The global coronavirus 2019 (COVID-19) pandemic required vaccination even in children to reduce infection. We report on the development of acute kidney injury (AKI) and minimal change disease (MCD) nephrotic syndrome (NS), shortly after the first injection BNT162b2 COVID-19 vaccine (Pfizer-BioNTech). A 12-year-old previously healthy boy was referred to our hospital with complaints of peripheral edema and nephrotic range proteinuria. Nine days earlier he had received his first injection BNT162b2 COVID-19 vaccine (Pfizer-BioNTech). Seven days after injection, he developed leg edema, which rapidly progressed to anasarca with significant weight gain. On admission, serum creatinine was 1.3 mg/dL and 24-hour urinary protein excretion was 4 grams with fluid overload. As kidney function continued to decline over the next days, empirical steroid treatment and renal replacement therapy with ultrafiltration were started and kidney biopsy was performed. Seven days after steroid therapy, kidney function began to improve, gradually returning to normal. The association of MCD, nephrotic syndrome and AKI hasn't been previously described following the Pfizer-BioNTech COVID-19 vaccine in pediatric population, but this triad has been reported in adults. We need further similar case reports to establish the real incidence of this possible vaccine side effect.
2019年全球新型冠状病毒肺炎（COVID-19）大流行，即使对儿童也需要接种疫苗以减少感染。我们报告了一名12岁儿童在首次注射BNT162b2 COVID-19疫苗（辉瑞-生物科技公司）后不久发生急性肾损伤（AKI）和微小病变病（MCD）肾病综合征（NS）的情况。一名此前健康的12岁男孩因外周水肿和肾病范围蛋白尿前来我院就诊。九天前他接种了第一剂BNT162b2 COVID-19疫苗（辉瑞-生物科技公司）。注射后七天，他出现腿部水肿，并迅速发展为全身性水肿，体重显著增加。入院时，血清肌酐为1.3mg/dL，24小时尿蛋白排泄量为4克，伴有液体超负荷。在接下来的几天里，随着肾功能持续下降，开始进行经验性类固醇治疗和超滤肾脏替代治疗，并进行了肾活检。类固醇治疗七天后，肾功能开始改善，逐渐恢复正常。在儿科人群中，辉瑞-生物科技公司COVID-19疫苗接种后，MCD、肾病综合征和AKI的关联此前尚未见报道，但在成人中已有此三联征的报告。我们需要更多类似的病例报告来确定这种可能的疫苗副作用的实际发生率。
