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Fatal thrombotic microangiopathy with rhabdomyolysis as an initial symptom after the first dose of mRNA–1273 vaccine: A case report

We report a case of a Japanese man with severe rhabdomyolysis and multiple thrombosis of arterioles after the first dose of mRNA-1273 vaccine. He developed rapidly progressive rhabdomyolysis and infarctions of multiple organs. Antiplatelet factor 4 antibody test was negative. Despite the intensive s...

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Autores principales: Kamura, Yuya, Terao, Toshiki, Akao, Satoshi, Kono, Yumi, Honma, Koichi, Matsue, Kosei
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8853962/
https://www.ncbi.nlm.nih.gov/pubmed/35189339
http://dx.doi.org/10.1016/j.ijid.2022.02.031
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author Kamura, Yuya
Terao, Toshiki
Akao, Satoshi
Kono, Yumi
Honma, Koichi
Matsue, Kosei
author_facet Kamura, Yuya
Terao, Toshiki
Akao, Satoshi
Kono, Yumi
Honma, Koichi
Matsue, Kosei
author_sort Kamura, Yuya
collection PubMed
description We report a case of a Japanese man with severe rhabdomyolysis and multiple thrombosis of arterioles after the first dose of mRNA-1273 vaccine. He developed rapidly progressive rhabdomyolysis and infarctions of multiple organs. Antiplatelet factor 4 antibody test was negative. Despite the intensive supportive care, including aggressive fluid administration, hemodialysis, administration of anticoagulants, high-dose steroid, and eculizumab, the patient ultimately died of multiple organ failure. Autopsy revealed multiple thrombosis in the arterioles and organ necrosis. Low serum complements and C3 deposition in the renal glomeruli detected by immunofluorescence suggested a possible immune-mediated mechanism. To our knowledge, this is the first case report of rhabdomyolysis and multiple thrombosis of the arterioles as an adverse event following COVID-19 vaccination.
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spelling pubmed-88539622022-02-18 Fatal thrombotic microangiopathy with rhabdomyolysis as an initial symptom after the first dose of mRNA–1273 vaccine: A case report Kamura, Yuya Terao, Toshiki Akao, Satoshi Kono, Yumi Honma, Koichi Matsue, Kosei Int J Infect Dis Article We report a case of a Japanese man with severe rhabdomyolysis and multiple thrombosis of arterioles after the first dose of mRNA-1273 vaccine. He developed rapidly progressive rhabdomyolysis and infarctions of multiple organs. Antiplatelet factor 4 antibody test was negative. Despite the intensive supportive care, including aggressive fluid administration, hemodialysis, administration of anticoagulants, high-dose steroid, and eculizumab, the patient ultimately died of multiple organ failure. Autopsy revealed multiple thrombosis in the arterioles and organ necrosis. Low serum complements and C3 deposition in the renal glomeruli detected by immunofluorescence suggested a possible immune-mediated mechanism. To our knowledge, this is the first case report of rhabdomyolysis and multiple thrombosis of the arterioles as an adverse event following COVID-19 vaccination. The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. 2022-04 2022-02-18 /pmc/articles/PMC8853962/ /pubmed/35189339 http://dx.doi.org/10.1016/j.ijid.2022.02.031 Text en © 2022 The Author(s) Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
spellingShingle Article
Kamura, Yuya
Terao, Toshiki
Akao, Satoshi
Kono, Yumi
Honma, Koichi
Matsue, Kosei
Fatal thrombotic microangiopathy with rhabdomyolysis as an initial symptom after the first dose of mRNA–1273 vaccine: A case report
title Fatal thrombotic microangiopathy with rhabdomyolysis as an initial symptom after the first dose of mRNA–1273 vaccine: A case report
title_full Fatal thrombotic microangiopathy with rhabdomyolysis as an initial symptom after the first dose of mRNA–1273 vaccine: A case report
title_fullStr Fatal thrombotic microangiopathy with rhabdomyolysis as an initial symptom after the first dose of mRNA–1273 vaccine: A case report
title_full_unstemmed Fatal thrombotic microangiopathy with rhabdomyolysis as an initial symptom after the first dose of mRNA–1273 vaccine: A case report
title_short Fatal thrombotic microangiopathy with rhabdomyolysis as an initial symptom after the first dose of mRNA–1273 vaccine: A case report
title_sort fatal thrombotic microangiopathy with rhabdomyolysis as an initial symptom after the first dose of mrna–1273 vaccine: a case report
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8853962/
https://www.ncbi.nlm.nih.gov/pubmed/35189339
http://dx.doi.org/10.1016/j.ijid.2022.02.031
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