Division of Nephrology, Department of Internal Medicine, Teikyo University Chiba Medical Center, Japan.
Department of Pathology, Teikyo University Chiba Medical Center, Japan.
Intern Med. 2023 Apr 1;62(7):1043-1048. doi: 10.2169/internalmedicine.1027-22. Epub 2023 Feb 1.
As coronavirus disease 2019 (COVID-19) vaccine booster campaigns progress worldwide, new reports of complications following COVID-19 vaccination have emerged. We herein report a case of new-onset anti-glomerular basement membrane (GBM) disease concomitant with myeloperoxidase-antineutrophil cytoplasmic antibody positivity concurrent with high levels of interleukin (IL)-26 following the second dose of the Pfizer-BioNTech COVID-19 vaccine. The temporal association with vaccination in this case suggests that an enhanced neutrophilic immune response through IL-26 may have triggered necrotizing glomerulonephritis and a T-cell-mediated immune response to GBMs, leading to the development of anti-GBM antibodies, with an enhanced B-cell response after the vaccination triggering anti-GBM IgG and the onset of anti-GBM disease.
随着 2019 年冠状病毒病（COVID-19）疫苗加强针运动在全球范围内的推进，新出现了一些与 COVID-19 疫苗接种相关的并发症报告。我们在此报告了一例新发病例，即第二剂辉瑞-生物科技 COVID-19 疫苗接种后，同时出现抗肾小球基底膜（GBM）疾病、髓过氧化物酶-抗中性粒细胞胞质抗体阳性和白细胞介素（IL）-26 水平升高。在这种情况下，与疫苗接种的时间关联表明，通过 IL-26 增强的中性粒细胞免疫反应可能引发了坏死性肾小球肾炎和针对 GBM 的 T 细胞介导的免疫反应，导致抗 GBM 抗体的产生，接种疫苗后增强的 B 细胞反应触发了抗 GBM IgG 的产生和抗 GBM 疾病的发生。
