Thrombocytopenia, anasarca, fever, reticulum fibrosis, and organomegaly syndrome triggered by vaccination against SARS-CoV-2 messenger RNA vaccine.

Abstract

We describe a rare case of thrombocytopenia, anasarca, fever, reticulum fibrosis, and organomegaly (TAFRO) syndrome that developed after the second vaccination against SARS-CoV-2 (mRNA1273, manufactured by Moderna Co.) in a healthy 26-year-old male. He developed a prolonged high fever and intermittent non-localised abdominal pain soon after vaccination followed by impaired renal function and thrombocytopenia; as well as assumed cytokine storm due to serum levels of triglyceride and total cholesterol, and high serum levels of ferritin, soluble interleukin 2 receptor, soluble CD14, interleukin 6, and vascular endothelial growth factor. Based on these findings, the patient was diagnosed with TAFRO syndrome. His condition was refractory against glucocorticoid, tocilizumab, and rituximab, and temporary haemodialysis was necessary. We speculate that the mRNA vaccine triggered a modification of the immune system and caused the development of TAFRO syndrome.