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接种疫苗后发生 TAFRO 综合征 1 例,环孢素治疗成功。

A case of TAFRO syndrome after vaccination, successfully treated with cyclosporine.

机构信息

Department of Cardiovascular and Renal Medicine, Hyogo Medical University, 1-1 Mukogawa-Cho, Nishinomiya, Hyogo, 663-8501, Japan.

Department of Nephrology, Konan Medical Center, 1-5-16 Kamokogahara, Higashinada-Ku, Kobe, Hyogo, 658-0064, Japan.

出版信息

BMC Nephrol. 2024 Jun 13;25(1):196. doi: 10.1186/s12882-024-03630-x.

Abstract

BACKGROUND

TAFRO syndrome is a rare disorder that causes thrombocytopenia, generalized oedema, fever, organ enlargement, and renal impairment. Few reports have suggested an association with vaccines, and few cases have undergone renal biopsy. TAFRO syndrome is often severe and fatal, and its cause is unknown. We report a case of TAFRO syndrome that occurred after vaccination with the coronavirus disease 2019 (COVID-19) vaccine.

CASE PRESENTATION

An 82-year-old woman received two doses of the BNT162b2 mRNA vaccine 3 weeks apart. Two weeks later, she was admitted to the hospital with oedema, accompanied with renal failure and thrombocytopenia. After close examination, she was diagnosed with TAFRO syndrome. She was treated with steroids, cyclosporine, and thrombopoietin receptor agonists. The patient was discharged after several months in remission.

CONCLUSIONS

Although an incident of TAFRO syndrome after COVID-19 vaccination has been previously reported, this is a rare case in which the patient went into remission and was discharged. A renal biopsy was also performed in this case, which was consistent with previous reports. The favorable treatment course for TAFRO syndrome provides valuable insights.

摘要

背景

TAFRO 综合征是一种罕见的疾病,可导致血小板减少症、全身性水肿、发热、器官肿大和肾功能损害。有少数报告提示与疫苗有关,少数病例进行了肾活检。TAFRO 综合征通常很严重且致命,其病因不明。我们报告了一例接种 2019 年冠状病毒病(COVID-19)疫苗后发生的 TAFRO 综合征病例。

病例介绍

一名 82 岁女性在相隔 3 周的时间内接种了两剂 BNT162b2 mRNA 疫苗。两周后,她因水肿、肾衰竭和血小板减少症住院。经过仔细检查,她被诊断为 TAFRO 综合征。她接受了类固醇、环孢素和血小板生成素受体激动剂治疗。经过数月的缓解后,患者出院。

结论

虽然之前有报道 COVID-19 疫苗接种后发生 TAFRO 综合征的病例,但本例患者病情缓解并出院,较为罕见。此外,该病例还进行了肾活检,与之前的报告一致。TAFRO 综合征的良好治疗过程提供了有价值的见解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b791/11177486/94fc2abb5a6e/12882_2024_3630_Fig1_HTML.jpg

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