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Background & Aims: The BioNTech‐Pfizer vaccine is the only vaccine offered to children among all available vaccines. However, limited evidence is available about the clinical outcomes of COVID‐19 vaccines, especially among children and adolescents. This review offers a comprehensive and up‐to‐date overview of the BioNTech‐Pfizer vaccine's current information on children and adolescents. Methods: The review was conducted following the PRISMA guidelines; a comprehensive search was performed in PubMed, Scopus, MEDLINE, and EMBASE databases for research publications COVID‐19 published between December 2019 and October 2021. All studies reporting on the outcomes of vaccinating children in their respective institutes were included. Results: A total of 78 vaccinated children and adolescents from six studies were included. The majority of symptomatic vaccinated pediatrics were males (71%). The mean age was 15.6 years, and the BMI was 24.1. The most common clinical symptoms were found in chest pain (35%), fever (32%), and myalgia (17%). The most common cardiac symptom in the EKG results was ST elevation, and 35% of vaccinated pediatrics had elevated serum troponin. The hospitalization, including ICU admission, was lower than in unvaccinated groups. Statistically significant associations (p ≤ 0.05) were found in two symptoms (fever and headache) between the vaccinated and nonvaccinated pediatric groups. Conclusions: Although we found better outcomes in the vaccinated group versus the nonvaccinated pediatric group, more studies are still crucial to further understand the specific etiology underlying postvaccination, particularly myocarditis, psychological impact, and other cardiac clinical symptoms in children and adolescents after receiving the BioNTech‐Pfizer vaccine. [ABSTRACT FROM AUTHOR]

The ocular manifestations of RA such as episcleritis and scleritis are important to consider in this patient, as the bilateral conjunctival injection observed in this patient may reflect an underlying systemic inflammatory process. Although the patient was at a low risk for developing ARF, as it is significantly less common in the US than underdeveloped countries, the presence of clinical carditis, polyarthralgia, fever of >=38.5°C, and significantly elevated markers of inflammation are sufficient to fulfill the 2015 Jones criteria for rheumatic fever and support the diagnosis of ARF in this patient. The angiographic findings suggestive of coronary vasculitis, and biopsy-proven vasculitis of small to medium-sized testicular arteries led to the specific diagnosis of PAN, which enabled the patient to receive the appropriate treatment for his underlying disease. [Extracted from the article]

Coronavirus disease 2019 (COVID‐19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) has led to an unprecedented setback for global economy and health. Vaccination is one of the most effective interventions to substantially reduce severe disease and death due to SARS‐CoV‐2 infection. Vaccination programmes are being rolled out globally, but most of these vaccines have been approved without extensive studies on their side‐effects and efficacy. Recently, new‐onset autoimmune phenomena after COVID‐19 vaccination have been reported increasingly (e.g. immune thrombotic thrombocytopenia, autoimmune liver diseases, Guillain–Barré syndrome, IgA nephropathy, rheumatoid arthritis and systemic lupus erythematosus). Molecular mimicry, the production of particular autoantibodies and the role of certain vaccine adjuvants seem to be substantial contributors to autoimmune phenomena. However, whether the association between COVID‐19 vaccine and autoimmune manifestations is coincidental or causal remains to be elucidated. Here, we summarize the emerging evidence about autoimmune manifestations occurring in response to certain COVID‐19 vaccines. Although information pertaining to the risk of autoimmune disease as a consequence of vaccination is controversial, we merely propose our current understanding of autoimmune manifestations associated with COVID‐19 vaccine. In fact, we do not aim to disavow the overwhelming benefits of mass COVID‐19 vaccination in preventing COVID‐19 morbidity and mortality. These reports could help guide clinical assessment and management of autoimmune manifestations after COVID‐19 vaccination. [ABSTRACT FROM AUTHOR]

Background: The clinical value of perineural invasion (PNI) in patients with localized prostate cancer (PCa) is widely explored. However, its role in metastatic PCa (mPCa) remains unknown. Objectives: We aim to investigate the clinical significance of PNI in patients with mPCa. Materials and methods: Data of 515 mPCa patients between 2012 and 2018 were retrospectively studied. PNI and its intensity were identified by prostate biopsy. The prognostic value of PNI was evaluated by Kaplan–Meier curves and Cox proportional‐hazards model. Results: Perineural invasion was detected in 170/515 (33.0%) cases. Among them 73/170 (42.9%) and 97/170 (57.1%) harbored unifocal PNI (uni‐PNI) and multifocal PNI (multi‐PNI), respectively. Compared to patients without PNI, those with PNI had statistically shorter castration‐resistant PCa‐free survival (CFS) and numerically shorter overall survival (OS) (mCFS: 15.4‐ vs. 18.5‐Mo, p = 0.015; mOS: 63.8‐ vs. 71.4‐Mo, p = 0.108). Patients harboring multi‐PNI were associated with poorer clinical outcomes than those with uni‐PNI (mCFS: 12.4‐ vs. 18.0‐Mo, p = 0.040; mOS: 39.7‐Mo vs. NR, p = 0.018) or those without PNI (mCFS: 12.4‐ vs. 18.5‐Mo, p = 0.002; mOS: 39.7‐ vs. 71.4‐Mo, p = 0.002). Totally, neither uni‐PNI nor multi‐PNI was an independent risk factor impacting survival outcomes in multivariate analyses. While remarkably, for patients with favorable/intermediate‐risk mPCa, multi‐PNI was an independent adverse prognosticator for both CFS and OS (CFS: HR: 1.705, 95% CI: 1.029–2.825, p = 0.038; OS: HR: 3.294, 95% CI: 1.464–7.413, p = 0.004). Discussion and Conclusion: This study filled the blank of the clinical significance of PNI in mPCa. We found that multi‐PNI could distinguish men with relatively poor prognosis from patients initially regarded as with favorable survival outcomes by other prognosticators, and thus, avoid disease underestimation in this group of patients. Our finding would help physicians have a deeper understanding of the heterogeneity of mPCa and make better individualized therapeutic strategy. [ABSTRACT FROM AUTHOR]

In this issue of I Nephrology i , three case series are published with I denovo i or relapse of different glomerulonephritides after COVID-19 mRNA vaccination. While vaccine efficacy has become palpable in many countries with a high vaccination rate,1 there is mounting concern on the increasing incidence of vaccine-associated adverse events. De novo and relapsing glomerulonephritis after COVID-19 vaccination: how much do we know?. [Extracted from the article]

Kidney biopsy confirmed IgA nephropathy with Oxford classification M1E0S0T0-C0 without features suggestive of lupus nephritis. As flare of IgA nephropathy after COVID-19 vaccination is uncommon and mostly benign, it should not be a reason for deterring vaccination. A 28 years old lady with history of microscopic haematuria for 5 years underwent a pre-scheduled kidney biopsy for suspected IgA nephropathy. [Extracted from the article]