Hemolytic Uremic Syndrome: A COVID-19 Vaccine Reaction Case Report.

Thelma Alalbila Aku, Eugene Kobla Dordoye, Theodore Ofori Apraku, Adwoa Ansomaa Gyamera, Peter Yamoah, Patrick Adjei
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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.

溶血性尿毒症:COVID-19 疫苗反应病例报告。
世界卫生组织于 2020 年 1 月 30 日宣布 2019 年冠状病毒病(COVID-19)为国际关注的突发公共卫生事件,并于 2020 年 3 月 11 日宣布其为大流行病。事实证明,疫苗对于控制并最终根除这种病毒感染至关重要。曾有报道称使用疫苗会引发血栓栓塞事件,但从现有资料来看,还没有关于黑人男性非典型溶血性尿毒症(HUS)病例的报道。我们报告了一例 43 岁的撒哈拉以南非洲黑人男性 c5d 在接种第二剂 COVID-19 疫苗后 3 天出现寒战、发热和全身疼痛。入院时出现血小板减少、溶血性贫血和急性肾损伤,初步诊断为疟疾。他先接受了肠外青蒿琥酯治疗,然后口服蒿甲醚/氟苯胍。他的溶血性贫血被认为是疟疾引起的溶血。不过,后来重新评估后,诊断为溶血性尿毒症综合征,每天口服 50 毫克泼尼松龙,症状得到缓解,一周后他恢复了工作。尽管大规模疫苗接种是控制 COVID-19 传播的关键策略,但仍应进行严格观察,以确认异常补体激活的触发风险。尤其是在黑猩猩腺病毒感染疫苗的情况下,更应进一步观察。
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