Acute tubulointerstitial nephritis following coronavirus disease 2019 mRNA vaccination: a pediatric case report.

IF 1 Q4 UROLOGY & NEPHROLOGY CEN Case Reports Pub Date : 2024-10-31 DOI:10.1007/s13730-024-00945-4

Gakushi Eguchi, Miki Murakoshi, Futaba Miyaoka, Asami Shimbo, Hitoshi Irabu, Toru Kanamori, Tomohiro Udagawa, Tomohiro Morio, Masaki Shimizu

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Abstract

Coronavirus disease 2019 (COVID-19) mRNA vaccines have been linked to various kidney adverse events including acute tubulointerstitial nephritis (ATIN). This report describes a 15-year-old female who developed persistent fever and fatigue 54 days after receiving her second dose of the BNT162b2 2 SARS-CoV-2 vaccine. She presented with elevated serum creatinine and urinary β2-microglobulin (β2MG) levels. Kidney biopsy revealed mononuclear infiltrate with some eosinophils, confirming the diagnosis of ATIN. Repeatedly positive lymphocyte transformation test results for the vaccine suggested a relationship between the vaccine and interstitial nephritis. Initially, treatment with prednisolone was effective. However, an increase in urinary β2MG level was observed 7 months later, and the introduction of mycophenolate mofetil (MMF) allowed for the gradual reduction and eventual cessation of prednisolone. This case represents one of the rare pediatric instances of ATIN following COVID-19 vaccination. MMF can be an effective alternative in corticosteroid-dependent cases.

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接种冠状病毒 2019 mRNA 疫苗后出现急性肾小管间质性肾炎：一例儿科病例报告。

2019 年冠状病毒病（COVID-19）mRNA 疫苗与各种肾脏不良事件有关，包括急性肾小管间质性肾炎 (ATIN)。本报告描述了一名 15 岁女性在接种第二剂 BNT162b2 2 SARS-CoV-2 疫苗 54 天后出现持续发热和乏力。她出现血清肌酐和尿β2-微球蛋白（β2MG）水平升高。肾活检发现单核浸润，伴有一些嗜酸性粒细胞，确诊为 ATIN。疫苗淋巴细胞转化试验结果反复呈阳性，表明疫苗与间质性肾炎之间存在关系。起初，泼尼松龙治疗有效。然而，7 个月后观察到尿β2MG 水平升高，于是开始使用霉酚酸酯（MMF），逐渐减少并最终停止使用泼尼松龙。该病例是罕见的接种 COVID-19 疫苗后出现 ATIN 的儿科病例之一。对于依赖皮质类固醇的病例，MMF是一种有效的替代药物。

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来源期刊

CEN Case Reports UROLOGY & NEPHROLOGY-

CiteScore

1.90

自引率

0.00%

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期刊介绍： Clinical and Experimental Nephrology (CEN) Case Reports is a peer-reviewed online-only journal, officially published biannually by the Japanese Society of Nephrology (JSN). The journal publishes original case reports in nephrology and related areas. The purpose of CEN Case Reports is to provide clinicians and researchers with a forum in which to disseminate their personal experience to a wide readership and to review interesting cases encountered by colleagues all over the world, from whom contributions are welcomed.