Atypical Hemolytic Uremic Syndrome Associated with BNT162b2 mRNA COVID-19 Vaccine in a Kidney Transplant Recipient: A Case Report and Literature Review

被引：0

作者：

Pattonieri, Eleonora Francesca ^{[1
]}

Gregorini, Marilena ^{[1
,2
]}

Grignano, Maria Antonietta ^{[1
]}

Islami, Tefik ^{[1
]}

D'Ambrosio, Gioacchino ^{[3
,4
]}

Ardissino, Gianluigi ^{[5
]}

Rampino, Teresa ^{[1
,2
]}

机构：

[1] Fdn IRCCS Policlin San Matteo, Unit Nephrol Dialysis & Transplants, I-27100 Pavia, Italy

[2] Univ Pavia, Dept Internal Med & Therapeut, I-27100 Pavia, Italy

[3] Univ Pavia, Dept Mol Med, Anat Pathol Unit, I-27100 Pavia, Italy

[4] Fdn IRCCS Policlin San Matteo, I-27100 Pavia, Italy

[5] Fdn IRCCS CaGranda Osped Maggiore Policlin, Ctr HUS Prevent Control & Management, I-20162 Milan, Italy

来源：

INFECTIOUS DISEASE REPORTS | 2025年 / 17卷 / 01期

关键词：

BNT162b2; COVID-19; vaccination; hemolytic uremic syndrome; acute kidney injury; kidney transplant;

D O I：

10.3390/idr17010014

中图分类号：

R51 [传染病];

学科分类号：

100401 ;

摘要：

Case Report: We report a case of a 37-year-old female with kidney transplant, who was admitted at our hospital due to worsening renal function, nephrotic proteinuria, and anemia developed 21 days after the second dose of BNT162b2 COVID-19 vaccine (Pfizer-BioNTech). Laboratory tests revealed hemolytic anemia, thrombocytopenia, and acute kidney injury. Given the clinical picture of Thrombotic Micro-angiopathy (TMA) and severe renal impairment, plasma exchange (PEX) and dialysis were immediately started. Laboratory workup showed low C3 and C4 levels, normal activity of ADAMTS13, and the absence of anti-factor H antibodies. Molecular biology investigations revealed a heterozygous variant in exon 22 (SCR20) of the CFH gene (c.3628C>T; p.Arg1210Cys) described as an atypical Hemolytic Uremic Syndrome (aHUS) causative mutation. Our patient completed two sessions of PEX followed by eculizumab treatment with hematological improvement but no recovery of renal function. This is the first reported case of aHUS triggered by SARS-CoV-2 vaccination in a kidney transplant patient without recovery of renal function. Conclusion: Although rare, clinicians should be aware of possible nephrological complications that may appear after vaccination.

引用

页数：10

共 41 条

[41] New insights into postrenal transplant hemolytic uremic syndrome [J].

Zuber, Julien ;

Le Quintrec, Moglie ;

Sberro-Soussan, Rebecca ;

Loirat, Chantal ;

Fremeaux-Bacchi, Veronique ;

Legendre, Christophe .

NATURE REVIEWS NEPHROLOGY, 2011, 7 (01) :23-35

← 1 2 3 4 5 →