A Systematic Review of Perinuclear Antineutrophil Cytoplasmic Antibody-Associated Glomerulonephritis Following Coronavirus Disease 2019 Vaccination: A 2024 Update.

Autor:	Ogieuhi IJ; Physiology, University of Benin, Benin City, NGA.; General Medicine, Siberian State Medical University, Tomsk, RUS., Suman F; Internal Medicine, Ghulam Muhammad Mahar Medical College, Sukkur, PAK., Kumari N; Internal Medicine, Ghulam Muhammad Mahar Medical College, Sukkur, PAK., Manita B; Internal Medicine, Ghulam Muhammad Mahar Medical College, Sukkur, PAK., Kumari D; Internal Medicine, Peoples University of Medical and Health Sciences, Nawabshah, PAK., Devi J; Pharmacy, Clifton Medical Services, Karachi, PAK., Abdalla M; Internal Medicine, Dallah Hospital, Riyadh, SAU., Shabbo E; School of Medicine, Ahfad University for Women, Omdurman, SDN., Patel U; Internal Medicine, Medical College, Baroda and Sir Sayaji General (SSG) Hospital, Vadodara, IND., Samreen I; Medical School, Deccan College of Medical Sciences, Hyderabad, IND., Mohamed KH; Neurology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, GBR., Ahmed Z; Internal Medicine, Mayo Hospital, Lahore, PAK., Nasir H; Internal Medicine, Mayo Hospital, Lahore, PAK.
Jazyk:	angličtina
Zdroj:	Cureus [Cureus] 2024 Apr 30; Vol. 16 (4), pp. e59390. Date of Electronic Publication: 2024 Apr 30 (Print Publication: 2024).
DOI:	10.7759/cureus.59390
Abstrakt:	Antineutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis (GN) is an immune-mediated kidney disease characterized by the inflammation of small blood vessels in the kidney, leading to renal impairment and potentially irreversible damage. Concerns have been raised over the reports of myeloperoxidase/perinuclear (MPO/p) ANCA GN following the coronavirus disease 2019 (COVID-19) vaccination. Our study provides a comprehensive insight into perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA) GN after COVID-19 vaccination. We conducted a comprehensive literature search on PubMed, Cochrane Library, and EMBASE using the Medical Subject Headings (MeSH) terms related to "covid-19 vaccine," "glomerulonephritis," "p-ANCA," and "MPO-ANCA" up to March 5, 2024, to include cases of p-ANCA-associated GN following COVID-19 vaccination. Of the 4,102 articles, we included 29, reporting 35 patients demonstrating COVID-19 vaccine-induced p-ANCA GN, with 23 (65.7%) females and a median age of 69 years (mean ± SD = 63.22 ± 16). Twenty-six (74.28%) patients received the mRNA vaccine (Pfizer = 19, Moderna = 7). Seventeen (48.57%) patients presented with p-ANCA GN after the second dose of the COVID-19 vaccine, with a median gap of 19 days (1-84 days). Constitutional symptoms (54.28%) and acute kidney injury (42.85%) were the most reported initial presentations, and elevated serum creatinine (mean peak serum creatinine = 4.98 ± 5.02 mg/dL), hematuria, and proteinuria were the laboratory findings. MPO/p-ANCA was positive in 31 (88.6%) patients. All patients underwent renal biopsy, and crescentic GN was the most common finding among 27 (77.14%) patients. Management of p-ANCA GN included steroids in 30 (85.71%) patients, followed by rituximab (28.57%), and plasmapheresis (22.86%). Most patients responded well to treatment, with complete remission in 29 (82.86%) and relapse in four (11.42%) patients. Two patients did not achieve remission and became dialysis dependent. ANCA-associated GN is a rare and life-threatening complication of the COVID-19 vaccine, necessitating urgent evaluation and management. COVID-19 vaccine-induced p-ANCA GN should be included in the differential diagnoses of patients presenting with kidney injury after vaccination. Competing Interests: The authors have declared that no competing interests exist. (Copyright © 2024, Ogieuhi et al.)
Databáze:	MEDLINE
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