Department of Nephrology and Rheumatology, Toranomon Hospital Kajigaya, Japan.
Department of Nephrology, Saga University Internal Medicine, Japan.
Intern Med. 2024 Oct 15;63(20):2821-2825. doi: 10.2169/internalmedicine.3247-23. Epub 2024 Feb 26.
We experienced three cases of a fever and subsequent severe, prolonged gross hematuria after COVID-19 vaccination. A kidney biopsy revealed immunoglobulin A (IgA) nephropathy, and electron microscopy showed two types of podocytopathy (podocyte damage): loss of foot processes from the glomerular basement membrane and foot process effacement. Mesangial interposition was also present in cases 1 and 3 but not in case 2. Podocytopathy is known to be a cause of proteinuria; however, the reactions to COVID-19 vaccination described here suggest that it may also be related to hematuria in IgA nephropathy.
我们遇到了三例接种 COVID-19 疫苗后发热和随后严重、持续的肉眼血尿。肾活检显示免疫球蛋白 A（IgA）肾病，电子显微镜显示两种足细胞病（足细胞损伤）：肾小球基底膜的足突从基底膜脱落和足突消失。系膜插入也存在于病例 1 和 3 中，但在病例 2 中不存在。足细胞病已知是蛋白尿的原因；然而，这里描述的 COVID-19 疫苗接种反应表明，它也可能与 IgA 肾病的血尿有关。
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