接种 COVID-19 疫苗后上皮下沉积物呈微球状结构的异常肾小球病变

Pub Date : 2024-07-01 DOI:10.25259/ijn_465_23

Tajamul H. Mir, Muzamil Latief, Alok Sharma, Bushra Jabeen, Farhat Abbas

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引用次数: 0

摘要

我们报告了一名 75 岁的健康男性在第二次注射 SARS CoV-2 疫苗复合物 ChAdOx1-nCoV-19 近两周后出现的肾小球病变，并伴有肾病综合征和急性肾损伤。肾脏活组织检查显示，肾小球病变为节段性 1 期膜性肾小球病变和塌陷性局灶节段性肾小球硬化模式，免疫荧光检查显示有免疫复合物。电子显微镜（EM）显示肾小球毛细血管壁上有球状微颗粒聚集。开始服用类固醇后，他的肾功能逐渐改善，蛋白尿明显减少。我们的病人似乎是唯一报告的由 SARS CoV-2 疫苗诱发的早期膜性肾病患者，其肾小球呈塌陷性局灶节段性硬化，免疫荧光显示免疫复合物，电镜显示由微球颗粒组成的上皮下沉积物。

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An Unusual Glomerulopathy with Subepithelial Deposits Having Microspherular Structures Following COVID-19 Vaccine

We report an unusual glomerulopathy with nephrotic syndrome and acute kidney injury almost two weeks after the second injection of SARS CoV-2 vaccine covishield, ChAdOx1-nCoV-19 in a 75-year-old healthy man. Kidney biopsy revealed segmental stage 1 membranous glomerulopathy and collapsing focal segmental glomerulosclerosis pattern with immune complexes on IF. Electron microscopy (EM) revealed aggregates of spherular microparticles along glomerular capillary walls. After starting him on steroids, his kidney functions gradually improved with significantly reduced proteinuria. Our patient seems to be the only reported SARS CoV-2 vaccine-induced early membranous nephropathy showing a collapsing focal segmental glomerulosclerosis pattern and immune complexes on IF with subepithelial deposits consisting of microspherular particles on EM.

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