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

Yuya Kamura, Toshiki Terao, Satoshi Akao, Yumi Kono, Koichi Honma, Kosei Matsue

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)322-325
Number of pages4
JournalInternational Journal of Infectious Diseases
Volume117
DOIs
Publication statusPublished - Apr 2022
Externally publishedYes

Keywords

  • complemental activation
  • COVID-19
  • mRNA-1273
  • rhabdomyolysis
  • SARS-CoV-2
  • thrombosis

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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