Department of Pediatrics, National Taiwan University Children's Hospital, Taipei, Taiwan.
Department of Pathology, National Taiwan University Hospital, Taipei, Taiwan.
J Formos Med Assoc. 2023 Nov;122(11):1125-1131. doi: 10.1016/j.jfma.2023.04.014. Epub 2023 Apr 26.
Cases of glomerulopathy after COVID-19 vaccination have been reported in the adult population, while only a few cases have been reported in children and adolescents. For better understanding of this association in pediatric population, we aimed to describe clinical course of patients with glomerulopathy within 60 days of COVID-19 vaccination who were under followed up in the pediatric nephrology department of National Taiwan University Children's Hospital.
We reviewed the clinical characteristics, vaccine types, and outcomes of patients with newly diagnosed glomerular diseases or relapse of underlying glomerulopathy within 60 days after COVID-19 vaccination at our facility between January 2021 and July 2022.
Thirteen pediatric patients were found to have newly diagnosed glomerular diseases or relapse from their underlying glomerulopathy after receiving their first, second, or third COVID-19 vaccines in our facility. Of the five pediatric patients with newly diagnosed glomerulopathy after vaccination, thin basement membrane nephropathy, idiopathic nephrotic syndrome, and hematuria have been identified. Seven patients had relapse episodes of underlying nephrotic syndrome and one patient with underlying isolated microscopic hematuria developed subnephrotic proteinuria after COVID-19 vaccination. All patients experienced remission or improvement with either immunosuppressive or conservative treatment during the follow-up period.
This is the largest case series to date of pediatric glomerulopathy after COVID-19 vaccination. From our report, patients with either newly diagnosed or relapse of glomerulopathy after vaccination had good outcomes, and receiving vaccination to prevent COVID-19 infection or complications should be encouraged in pandemic era under close monitoring kidney manifestations.
在成年人群中，已有报道称 COVID-19 疫苗接种后会发生肾小球病，但在儿童和青少年中，仅有少数病例报道。为了更好地了解儿科人群中的这种关联，我们旨在描述在台湾大学儿童医院儿科肾脏病科接受随访的 COVID-19 疫苗接种后 60 天内发生肾小球病的患者的临床病程。
我们回顾了 2021 年 1 月至 2022 年 7 月期间，在我们医院内首次、第二次或第三次 COVID-19 疫苗接种后 60 天内新诊断为肾小球疾病或潜在肾小球病复发的患者的临床特征、疫苗类型和结局。
在我们医院，发现 13 例儿科患者在接种第一、第二或第三剂 COVID-19 疫苗后新诊断为肾小球疾病或潜在肾小球病复发。在接种疫苗后新诊断为肾小球病的 5 例儿科患者中，已确定为基底膜变薄肾病、特发性肾病综合征和血尿。7 例患者出现潜在肾病综合征复发，1 例潜在孤立性镜下血尿患者在 COVID-19 疫苗接种后出现亚肾病范围蛋白尿。所有患者在随访期间均接受免疫抑制或保守治疗后缓解或改善。
这是迄今为止 COVID-19 疫苗接种后儿科肾小球病最大的病例系列。根据我们的报告，接种疫苗后新发或复发肾小球病的患者有良好的结局，在大流行时代，应鼓励接种疫苗以预防 COVID-19 感染或并发症，同时密切监测肾脏表现。
