Clinical Hospital of Botucatu Medical School of São Paulo State University, Professor Mário Rubens Guimarães Montenegro Avenue, Botucatu, Brazil.
Faculty of Medicine of Federal University of Maranhão, Gonçalves Dias Square, São Luís, Brazil.
Immun Inflamm Dis. 2024 Jul;12(7):e1270. doi: 10.1002/iid3.1270.
The emergence of new SARS-CoV-2 variants and the global COVID-19 pandemic spurred urgent vaccine development. While common vaccine side effects are well-documented, rare adverse events necessitate post-marketing surveillance. Recent research linked messenger RNA vaccines to thrombotic microangiopathy (TMA), a group of syndromes characterized by microvascular hemolytic anemia and thrombocytopenia. This report describes a new-onset atypical hemolytic-uremic syndrome (aHUS) occurring after COVID-19 vaccination and complements recent literature.
A previously healthy 25-year-old woman developed malaise, nausea, edema, and renal dysfunction 60 days postvaccination. Laboratory findings confirmed TMA diagnosis. Genetic testing for complement system mutations was negative. Kidney biopsy supported the diagnosis, and the patient required hemodialysis.
This case illustrates the rare occurrence of aHUS following COVID-19 vaccination, with unique characteristics compared to previous reports. Despite the critical role of vaccination in pandemic control, emerging adverse events, such as vaccine-related TMA, must be recognized and investigated. Additional clinical trials are imperative to comprehend the clinical features and pathophysiological mechanisms underlying TMA associated with COVID-19 vaccination.
新出现的 SARS-CoV-2 变体和全球 COVID-19 大流行促使人们紧急开发疫苗。虽然常见的疫苗副作用已有详细记录，但罕见的不良反应需要进行上市后监测。最近的研究将信使 RNA 疫苗与血栓性微血管病（TMA）联系起来，TMA 是一组以微血管溶血性贫血和血小板减少为特征的综合征。本报告描述了 COVID-19 疫苗接种后新出现的非典型溶血性尿毒综合征（aHUS），并补充了最近的文献。
一位先前健康的 25 岁女性在接种疫苗后 60 天出现不适、恶心、水肿和肾功能不全。实验室检查结果证实了 TMA 的诊断。补体系统基因突变的基因检测为阴性。肾脏活检支持该诊断，患者需要血液透析。
本病例说明了 COVID-19 疫苗接种后罕见发生 aHUS，与以往报告相比具有独特的特征。尽管疫苗在大流行控制中起着至关重要的作用，但必须认识和调查新出现的不良反应，如疫苗相关的 TMA。还需要进行更多的临床试验来了解与 COVID-19 疫苗接种相关的 TMA 的临床特征和病理生理机制。
