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ホシノ ジユンイチ
Hoshino Jiyun'ichi
星野 純一 所属 医学部 医学科（東京女子医科大学病院） 職種 教授・基幹分野長 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読なし |
| 表題 | Gross Hematuria after the COVID-19 mRNA Vaccination: Nationwide Multicenter Prospective Cohort Study in Japan |
| 掲載誌名 | 正式名：Kidney360 略 称：Kidney360 ISSNコード：26417650/26417650 |
| 掲載区分 | 国外 |
| 巻・号・頁 | pp.online |
| 著者・共著者 | Aoki Ryousuke, Nihei Yoshihito, Matsuzaki Keiichi, Suzuki Hitoshi, Kihara Masao, Ogawa Asa, Nishino Tomoya, Sanada Satoru, Yokote Shinya, Okabe Masahiro, Shirai Sayuri, Fukuda Akihiro, Hoshino Junichi, Kondo Daisuke, Yokoo Takashi, Kashihara Naoki, Narita Ichiei, Suzuki Yusuke |
| 発行年月 | 2024/07/08 |
| 概要 | BACKGROUND:In the past three years, cases of gross hematuria (GH) after the vaccination for coronavirus disease 2019 (COVID-19) in IgA nephropathy (IgAN) patients have been frequently reported worldwide. However, the post-event renal prognosis of these patients, their clinical backgrounds, and underlying mechanisms remain unknown. Therefore, we conducted a nationwide multicenter prospective cohort study in Japan.METHODS:We analyzed laboratory findings at the time of the first presentation to the hospital, and 3 and 6 months after in patients with GH after the vaccination, and histopathological findings in their kidney biopsy specimens. Moreover, changes in pathological biomarkers of IgAN such as galactose-deficient IgA1 (Gd-IgA1) and its immune complexes (ICs) were also evaluated.RESULTS:During the study period, 127 newly presenting with GH after the vaccination were enrolled, with a clear female bias (73.2%). GH was observed after the second or subsequent vaccinations in most patients (92.9%). Of the 37 patients undergoing kidney biopsy prior to the vaccination, 36 patients had been diagnosed with IgAN/IgA vasculitis (IgAV). In remaining 90 patients, 69 of the 70 who newly underwent kidney biopsy were diagnosed with IgAN (N=67)/IgAV (N=2). Their histopathology did not show a high incidence of acute lesions such as endocapillary hypercellularity and crescentic lesions. Most cases showed a temporary increase in proteinuria, but no sustained worsening in renal function. Among the biomarkers measured, serum Gd-IgA1 and ICs were comparable throughout the observation period, however, only urinary Gd-IgA1 was increased at the time of GH.CONCLUSIONS:We found that GH after the vaccination is more likely to occur in IgAN/IgAV patients, with a female bias, but without progressive exacerbation of renal function. Although further investigation is needed regarding causal relationship between vaccination and GH, this study provides many insights into the molecular mechanisms of G |
| DOI | 10.34067/KID.0000000000000498 |
| PMID | 38976886 |