国药集团新冠肺炎疫苗接种后系统性红斑狼疮合并肾功能衰竭1例

M. Mahmudpour, I. Nabipour, A. Esmailie, A. Amini
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摘要

新冠肺炎疫情的爆发揭示了病毒在糖尿病、自身免疫性疾病和心血管疾病等疾病发病机制中的作用。新冠肺炎导致糖尿病患者血糖控制恶化,部分患者甚至出现新发糖尿病,提示SARS-CoV-2可能在不同代谢途径中发挥干扰作用。此外,在COVID-19加重期间,已有灭活或新生自身免疫性疾病的报道,这表明病毒在刺激免疫系统和加重自身免疫性疾病中的致病作用通过不同的机制。本报告介绍了一例31岁男性系统性红斑狼疮(SLE)患者,在服用第三剂国药BIBP COVID-19(中国国药北京生物制品研究所)后出现流感样疾病、全身性水肿和肾功能衰竭。在住院期间,尽管活检证实为IV级狼疮肾炎,并使用甲基强的松龙和环磷酰胺进行标准治疗,但仍未达到适当的治疗反应。出院时给予每周三次常规血液透析。根据病程、活检和血清学检查的结果,本报告讨论了一些具有挑战性的情况。©2022,布什尔医学科学大学。版权所有。
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A Case of Systemic Lupus Erythematosus with Renal Failure Following the Administration of Sinopharm COVID-19 Vaccine
The outbreak of COVID-19 has been revealed some pathogenic mechanisms which are indicating the role of virus in the pathogenesis of diseases such as diabetes mellitus, autoimmune and cardiovascular diseases. COVID-19 results in deterioration of glycemic control in diabetic patients and even in some cases developed new onset diabetes mellitus which are indicating the possible interfering role of SARS-CoV-2 in different metabolic pathways. Furthermore, during COVID-19 exacerbation of inactivated or de novo autoimmune diseases have been reported which indicate the causative role of virus in the stimulation of immune system and aggravation of autoimmune diseases through different mechanisms. In this report, a 31 year old male case of systemic lupus erythematosus (SLE) has been introduced who developed flu like illness, generalized edema and renal failure following the administration of third dose of Sinopharm BIBP COVID-19 (Sinopharm Beijing institute of Biological Products, China). During hospital course, proper therapeutic response was not achieved despite biopsy proven class IV lupus nephritis and standard therapy with methyl prednisolone and cyclophosphamide. He discharged with administration of routine hemodialysis thrice weekly. According to the course of disease, findings of biopsy and serologic tests, there were some challenging scenarios that are discussed in this report. © 2022, Bushehr University of Medical Sciences. All rights reserved.
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