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Hemolytic Uremic Syndrome: A COVID-19 Vaccine Reaction Case Report
Thelma Alalbila Aku1, Eugene Kobla Dordoye2, Theodore Ofori Apraku3
1Pharmacy Practice Department, School of Pharmacy, University of Health and Allied Sciences, Ghana.
Insights
A rare case of atypical Hemolytic Uremic Syndrome (HUS) occurred in a Black male after a COVID-19 vaccine booster. Prompt diagnosis and treatment led to full recovery, highlighting the need for vigilance with vaccine-related adverse events.
Area of Science:
- Immunology
- Nephrology
- Infectious Diseases
Background:
- The COVID-19 pandemic necessitated rapid vaccine development and deployment.
- Vaccine-associated thromboembolic events have been reported, but atypical Hemolytic Uremic Syndrome (HUS) remains rare.
- This case highlights a potential, albeit uncommon, adverse event following immunization.
Observation:
- A 43-year-old Black male presented with symptoms mimicking malaria after his second COVID-19 vaccine booster.
- He developed thrombocytopenia, hemolytic anemia, and acute kidney injury.
- Initial malaria treatment was unsuccessful, prompting re-evaluation.
Findings:
- The patient was diagnosed with atypical Hemolytic Uremic Syndrome (HUS).
- Treatment with oral prednisolone resulted in complete resolution of symptoms and recovery.
- This is the first reported case of vaccine-associated atypical HUS in a Black male.
Implications:
- While COVID-19 vaccines are crucial, continued monitoring for rare adverse events is essential.
- This case suggests a potential link between certain vaccine types (adenovirus-vectored) and complement activation.
- Further research is needed to understand the mechanisms and identify at-risk populations.
Abstract:
The World Health Organization declared the Coronavirus disease of 2019 (COVID-19) a public health emergency of international concern on 30 January 2020, and a pandemic on 11 March 2020. Vaccines have proven to be vital in the effort to control and possibly eventually eradicate this viral infection. There have been reports of thromboembolic events associated with the use of vaccine but from available information, no reported case of atypical Hemolytic Uremic syndrome (HUS) in a black male has been described. We report a case of a 43-year-old black male Sub-Saharan African c5dwho presented with chills, fever, and generalized body aches of 3 days duration after receiving the second booster dose of the COVID-19 vaccine. He developed thrombocytopenia, hemolytic anaemia, and acute kidney injury on admission, and an initial diagnosis of malaria was made. He was managed with parenteral artesunate and then oral artemether/lumefantrine. His hemolytic anaemia was thought to be from malaria-associated hemolysis. This diagnosis was however later re-evaluated to hemolytic uremic syndrome and managed with 50mg daily oral prednisolone which resolved, and he resumed work a week later. Although mass vaccination is a key strategy to control the spread of COVID-19, critical observations should be made to confirm the risk of trigger for abnormal complement activation. Further observations should be made especially if it is a chimpanzee adenovirus-vectored vaccine.
