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1例新冠病毒疫苗接种后慢性乙型肝炎患者并发结节性多动脉炎:病例报告

Polyarteritis nodosa in a patient with chronic hepatitis B following COVID-19 vaccination: a case report.

作者信息

Abuhammad Aseel, Dukmak Osama N, Asad Diya, Bakri Izzeddin A, Attawna Saed I Y

机构信息

Al-Quds University Faculty of Medicine, Jerusalem, State of Palestine.

Al-Ahli Hospital, Hebron, State of Palestine.

出版信息

Oxf Med Case Reports. 2023 Sep 25;2023(9):omad092. doi: 10.1093/omcr/omad092. eCollection 2023 Sep.

Abstract

Different types of vasculitis have been reported after various vaccine administrations. Recently, the coronavirus disease 2019 (COVID-19) vaccine was one of the most common vaccine-induced vasculitis. Herein, we describe a 56-year-old male patient with chronic hepatitis B who presented with abdominal pain for 2 days, which was associated with vomiting and bloody diarrhea. He had a history of petechial rash for 25 days, multiple joint pain and lower limb weakness after the second dose of the COVID-19 vaccine. A skin biopsy showed medium-sized vessel vasculitis. Polyarteritis nodosa (PAN) was diagnosed depending on the American College of Rheumatology criteria. He was treated with steroids, plasmapheresis and antiviral medication with a good prognosis. In patients with a past medical history of chronic hepatitis B, the covid vaccine may be associated with an increased risk of developing a PAN, so clinicians should suspect the occurrence of this disease after COVID-19 vaccination.

摘要

据报道,在接种各种疫苗后会出现不同类型的血管炎。最近,2019冠状病毒病(COVID-19)疫苗是最常见的疫苗诱导性血管炎之一。在此,我们描述一名56岁的慢性乙型肝炎男性患者,他出现腹痛2天,伴有呕吐和血性腹泻。他在接种第二剂COVID-19疫苗后有25天的瘀点皮疹病史、多处关节疼痛和下肢无力。皮肤活检显示为中等大小血管血管炎。根据美国风湿病学会标准诊断为结节性多动脉炎(PAN)。他接受了类固醇、血浆置换和抗病毒药物治疗,预后良好。对于有慢性乙型肝炎既往病史的患者,新冠疫苗可能与发生PAN的风险增加有关,因此临床医生在COVID-19疫苗接种后应怀疑该病的发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e06/10530314/acc38312422e/omad092f1.jpg

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