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新冠病毒疫苗接种后发生的炎性风湿性疾病:病例系列报告及文献综述

Inflammatory rheumatic diseases developed after COVID-19 vaccination: presentation of a case series and review of the literature.

作者信息

Akkuzu G, Bes C, Özgür D S, Karaalioğlu B, Mutlu M Y, Yıldırım F, Atagündüz P, Gündüz A, Soy M

机构信息

Department of Rheumatology, University of Health Sciences, Başakşehir Çam and Sakura City Hospital, Istanbul, Turkey.

出版信息

Eur Rev Med Pharmacol Sci. 2023 Mar;27(5):2143-2151. doi: 10.26355/eurrev_202303_31587.

Abstract

OBJECTIVE

An increasing number of new on-set autoimmune-inflammatory rheumatic diseases (AIRD) after COVID-19 vaccination has begun to be reported in the literature. In this article, we present our patients with new-onset AIRD after vaccination for COVID-19 and review the literature on the subject.

PATIENTS AND METHODS

We investigated the clinical characteristics and laboratory parameters of previously described "newly developed AIRD in individuals recently vaccinated for COVID-19", in 22 cases vaccinated with one of the COVID-19 vaccines (BNT162b2 or CoronaVac) approved in our country.

RESULTS

We collected 22 cases (14 female, 63.6%) that developed an AIRD after COVID-19 vaccination. Mean age was 53±14.4 (24-87) years. The interval between the last dose of vaccination and the development of the first complaint was 23.9±19.5 (4-90) days. CoronaVac was administered to four patients, and the BNT162b2 to 18 patients. AIRD-related symptoms developed in 12 patients after the first dose, in 8 patients after the second dose, and in two patients after the third dose. Twelve out of the 22 (54.5%) cases were diagnosed with rheumatoid arthritis, two with SLE, and the remaining eight patients each with leukocytoclastic vasculitis, Sjogren's syndrome, psoriatic arthritis, ankylosing spondylitis, systemic sclerosis, mixed connective tissue disease, eosinophilic granulomatosis with polyangiitis, and inflammatory myositis, respectively. Six patients had a history of documented antecedent COVID-19 infection.

CONCLUSIONS

Autoimmune/inflammatory rheumatic diseases may develop after COVID-19 vaccinations. In the era of the COVID-19 pandemic, vaccination should be questioned carefully in newly diagnosed AIRD patients.

摘要

目的

文献中已开始报道越来越多在接种新冠病毒疫苗后新发的自身免疫性炎症性风湿性疾病(AIRD)。在本文中,我们介绍了接种新冠病毒疫苗后新发AIRD的患者,并对该主题的文献进行了综述。

患者与方法

我们调查了我国批准使用的一种新冠病毒疫苗(BNT162b2或科兴中维)接种者中先前描述的“近期接种新冠病毒疫苗个体中新发的AIRD”的临床特征和实验室参数。

结果

我们收集了22例在接种新冠病毒疫苗后发生AIRD的病例(14例女性,占63.6%)。平均年龄为53±14.4(24 - 87)岁。最后一剂疫苗接种与首次出现症状之间的间隔为23.9±19.5(4 - 90)天。4例患者接种了科兴中维,18例患者接种了BNT162b2。12例患者在第一剂后出现AIRD相关症状,8例在第二剂后出现,2例在第三剂后出现。22例病例中有12例(54.5%)被诊断为类风湿关节炎,2例为系统性红斑狼疮,其余8例患者分别诊断为白细胞破碎性血管炎、干燥综合征、银屑病关节炎、强直性脊柱炎、系统性硬化症、混合性结缔组织病、嗜酸性肉芽肿性多血管炎和炎性肌病。6例患者有新冠病毒感染病史。

结论

接种新冠病毒疫苗后可能会发生自身免疫性/炎症性风湿性疾病。在新冠疫情时代对新诊断的AIRD患者应谨慎考虑接种疫苗。

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