Łysak Kinga, Walulik Agata, Błaszkiewicz Michał, Gomułka Krzysztof
Faculty of Medicine, Medical University of Gdansk, 80-210 Gdansk, Poland.
Student Scientific Group of Internal Medicine and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland.
Vaccines (Basel). 2024 Jun 13;12(6):656. doi: 10.3390/vaccines12060656.
As vaccinations against the SARS-CoV-2 virus have become a crucial tool in controlling the spread of the disease, reports of rare health complications have emerged, including new-onset antineutrophil cytoplasmic autoantibodies (ANCA)-associated vasculitis (AAV). We systematically reviewed new-onset AAV following COVID-19 vaccination case reports and case series published in three databases before January 2024 following PRISMA guidelines to understand the characteristics of possible causal relationships or coincidences. In total, 404 articles were screened respectively by title, abstracts, and full-texts. Thirty-four papers fulfilled the inclusion criteria and have been analyzed, covering 44 patients with new-onset AAV after COVID-19 vaccination with no prior history of COVID-19 infection. Data regarding patients' metrics, comorbidities, vaccination characteristics, symptoms, diagnostics, treatment, and outcomes were investigated and summarized. The cohort consisted predominantly of females. AAV diagnosis was confirmed via biopsy, with renal dysfunction as a prevailing manifestation. In most cases, the first symptoms of AAV developed after the second dose; moreover, Pfizer-BioNTech was the most frequently administered vaccine among the analyzed cohort. Primary treatment involved glucocorticoid therapy, with a mostly favourable response. This systematic review aims to raise awareness among clinicians in the field regarding this rare but possible complication, to promote the prompt recognition and diagnosis of de novo ANCA-positive small-vessel vasculitis in timely association with SARS-CoV-2 vaccination.
由于针对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的疫苗接种已成为控制该疾病传播的关键工具，罕见健康并发症的报告不断出现，包括新发抗中性粒细胞胞浆抗体（ANCA）相关血管炎（AAV）。我们按照PRISMA指南，系统回顾了2024年1月之前在三个数据库中发表的关于新冠病毒疫苗接种后新发AAV的病例报告和病例系列，以了解可能的因果关系或巧合的特征。总共分别通过标题、摘要和全文筛选了404篇文章。34篇论文符合纳入标准并进行了分析，涵盖44例新冠病毒疫苗接种后新发AAV且无新冠病毒感染既往史的患者。对患者的指标、合并症、疫苗接种特征、症状、诊断、治疗和结局等数据进行了调查和总结。该队列主要为女性。通过活检确诊为AAV，主要表现为肾功能不全。在大多数情况下，AAV的首发症状在第二剂疫苗接种后出现；此外，在分析的队列中，辉瑞-BioNTech疫苗是最常接种的疫苗。主要治疗方法为糖皮质激素治疗，大多数患者反应良好。本系统评价旨在提高该领域临床医生对这种罕见但可能出现的并发症的认识，促进与新冠病毒疫苗接种及时相关的新发ANCA阳性小血管炎的快速识别和诊断。
