Boyle Therese, O'Lone Emma, Phua Elaine, Anderson Janet, Mather Amanda, Fernando Suran L
Department of Clinical Immunology and Allergy, Royal North Shore Hospital, St Leonards, Sydney, NSW 2065, Australia.
Faculty of Medicine and Health, University of Sydney, Camperdown, Sydney, NSW 2050, Australia.
Vaccines (Basel). 2023 Jun 26;11(7):1152. doi: 10.3390/vaccines11071152.
Successful vaccination has been the decisive factor in the overall decline of SARS-CoV2 infection related morbidity and mortality. However, global effects of the COVID-19 pandemic are ongoing, with reports of glomerular disease occurring in relation to both infection and vaccination. A particular rise in anti-GBM disease has been identified. Information is still emerging regarding the optimal management of such cases. We reviewed anti-GBM antibody detection rates at our test center over the past 5 years. We followed three patients with biopsy confirmed glomerular disease temporally related to COVID-19 vaccination. Each patient proceeded to receive subsequent COVID-19 vaccination as per immunologist recommendations. Further assessment included COVID-19 antibody testing in each case. A three-fold increase in significant anti-GBM antibody results noted at our center was associated with COVID infection in 10% of cases, and COVID vaccination in 25% of cases. We demonstrated that subsequent vaccination did not appear to lead to adverse effects including relapse in our three cases of COVID-19 vaccine-associated GN. We also identified positive COVID-19 antibody levels in two out of three cases, despite immunosuppression. We report a rise in anti-GBM antibody disease incidence. Our small study suggests that COVID-19 antibody testing can help determine COVID prophylaxis requirements, and subsequent vaccination with an alternative vaccine type appears safe.
成功接种疫苗一直是新冠病毒感染相关发病率和死亡率总体下降的决定性因素。然而，新冠疫情的全球影响仍在持续，有报告称感染和接种疫苗后均出现了肾小球疾病。已发现抗肾小球基底膜（GBM）疾病的发生率尤其有所上升。关于此类病例的最佳管理方法，相关信息仍在不断涌现。我们回顾了过去5年我们检测中心的抗GBM抗体检测率。我们追踪了3例经活检确诊的与新冠疫苗接种存在时间关联的肾小球疾病患者。每位患者均按照免疫学家的建议继续接种后续的新冠疫苗。进一步评估包括对每个病例进行新冠抗体检测。我们中心显著抗GBM抗体检测结果增加了三倍，其中10%的病例与新冠感染有关，25%的病例与新冠疫苗接种有关。我们证明，在我们3例与新冠疫苗相关的肾小球肾炎病例中，后续接种疫苗似乎并未导致包括复发在内的不良反应。我们还发现，在三分之二的病例中，尽管进行了免疫抑制治疗，但新冠抗体水平呈阳性。我们报告了抗GBM抗体疾病发病率的上升。我们的小型研究表明，新冠抗体检测有助于确定新冠预防需求，并且接种另一种类型的疫苗似乎是安全的。
