期刊
BMJ CASE REPORTS
卷 15, 期 8, 页码 -出版社
BMJ PUBLISHING GROUP
DOI: 10.1136/bcr-2022-250774
关键词
Haematology (incl blood transfusion); Transplantation
This case report describes a rare complication of autoimmune hemolytic anemia (AIHA) in a male teenager following vaccination with the Pfizer-BioNTech vaccine. Emergency splenectomy and treatment with eculizumab led to an improvement in the patient's condition.
A male in his teens with a history of liver transplant for biliary atresia (aged 2 years) and autoimmune haemolytic anaemia (AIHA, aged 6 years) presented with jaundice, dark urine, fatigue and chest discomfort that began 48 hours after the first dose of SARS-CoV-2 Pfizer-BioNTech vaccine (BNT162b2 mRNA). Investigations revealed a warm AIHA picture. Over 4 weeks the patient developed life-threatening anaemia culminating in haemoglobin of 35 g/L (after transfusion), lactate dehydrogenase of 1293 units/L and bilirubin of 228 mu mol/L, refractory to standard treatment with corticosteroids and rituximab. An emergency splenectomy was performed that slowed haemolysis but did not completely ameliorate it. Eculizumab, a terminal complement pathway inhibitor, was initiated to arrest intravascular haemolysis and showed a favourable response. AIHA is rare but described after the SARS-CoV-2 Pfizer-BioNTech vaccine. This case highlights the rare complication of AIHA, the use of emergency splenectomy for disease control, and the use of eculizumab.
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