tetano
Editor, Senior Moderator
Cureus
. 2022 Mar 28;14(3):e23577.
doi: 10.7759/cureus.23577. eCollection 2022 Mar.
A Rare Case of Atypical Hemolytic Uremia Syndrome Triggered by Influenza Vaccination
Sanjay Kumar[SUP] 1 [/SUP], Geeta Bhagia[SUP] 2 3 [/SUP], Jessica Kaae[SUP] 4 [/SUP]
Affiliations
Abstract
Atypical hemolytic uremic syndrome (aHUS) occurs in patients with defective alternative complement pathways, making them susceptible to thrombotic microangiopathy (thrombocytopenia, intravascular hemolysis, and renal failure), and is usually triggered by infectious agents. Influenza and Streptococcus pneumonia are known triggers for aHUS. However, influenza vaccination triggering aHUS is rarely reported. We present a 30-year-old male who presented with chills, abdominal discomfort, and night sweats after receiving the influenza vaccine. The patient had thrombocytopenia, elevated creatinine, blood urea nitrogen, liver enzymes, and bilirubin with schistocytes with peripheral smear. ADAMTS13 activity was normal so the patient was diagnosed with aHUS. The patient improved with eculizumab and was ultimately found to have a mutation in CD46, which made him susceptible to aHUS. This case shows patients with dysregulated alternative complement pathways may be predisposed to develop aHUS after receiving influenza vaccination.
Keywords: atypical hemolytic uremic syndrome; complement; hemolytic uremic syndrome; influenza vaccine; thrombotic microangiopathy (tma).
. 2022 Mar 28;14(3):e23577.
doi: 10.7759/cureus.23577. eCollection 2022 Mar.
A Rare Case of Atypical Hemolytic Uremia Syndrome Triggered by Influenza Vaccination
Sanjay Kumar[SUP] 1 [/SUP], Geeta Bhagia[SUP] 2 3 [/SUP], Jessica Kaae[SUP] 4 [/SUP]
Affiliations
- PMID: 35494971
- PMCID: PMC9045680
- DOI: 10.7759/cureus.23577
Abstract
Atypical hemolytic uremic syndrome (aHUS) occurs in patients with defective alternative complement pathways, making them susceptible to thrombotic microangiopathy (thrombocytopenia, intravascular hemolysis, and renal failure), and is usually triggered by infectious agents. Influenza and Streptococcus pneumonia are known triggers for aHUS. However, influenza vaccination triggering aHUS is rarely reported. We present a 30-year-old male who presented with chills, abdominal discomfort, and night sweats after receiving the influenza vaccine. The patient had thrombocytopenia, elevated creatinine, blood urea nitrogen, liver enzymes, and bilirubin with schistocytes with peripheral smear. ADAMTS13 activity was normal so the patient was diagnosed with aHUS. The patient improved with eculizumab and was ultimately found to have a mutation in CD46, which made him susceptible to aHUS. This case shows patients with dysregulated alternative complement pathways may be predisposed to develop aHUS after receiving influenza vaccination.
Keywords: atypical hemolytic uremic syndrome; complement; hemolytic uremic syndrome; influenza vaccine; thrombotic microangiopathy (tma).