{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T15:58:32Z","timestamp":1791907112020,"version":"4.3.4"},"reference-count":41,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T00:00:00Z","timestamp":1739232000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infectious Disease Reports"],"abstract":"<jats:p>Case Report: We report a case of a 37-year-old female with kidney transplant, who was admitted at our hospital due to worsening renal function, nephrotic proteinuria, and anemia developed 21 days after the second dose of BNT162b2 COVID-19 vaccine (Pfizer-BioNTech). Laboratory tests revealed hemolytic anemia, thrombocytopenia, and acute kidney injury. Given the clinical picture of Thrombotic Micro-angiopathy (TMA) and severe renal impairment, plasma exchange (PEX) and dialysis were immediately started. Laboratory workup showed low C3 and C4 levels, normal activity of ADAMTS13, and the absence of anti-factor H antibodies. Molecular biology investigations revealed a heterozygous variant in exon 22 (SCR20) of the CFH gene (c.3628C&gt;T; p.Arg1210Cys) described as an atypical Hemolytic Uremic Syndrome (aHUS) causative mutation. Our patient completed two sessions of PEX followed by eculizumab treatment with hematological improvement but no recovery of renal function. This is the first reported case of aHUS triggered by SARS-CoV-2 vaccination in a kidney transplant patient without recovery of renal function. Conclusion: Although rare, clinicians should be aware of possible nephrological complications that may appear after vaccination.<\/jats:p>","DOI":"10.3390\/idr17010014","type":"journal-article","created":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T03:41:57Z","timestamp":1739331717000},"page":"14","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Atypical Hemolytic Uremic Syndrome Associated with BNT162b2 mRNA COVID-19 Vaccine in a Kidney Transplant Recipient: A Case Report and Literature Review"],"prefix":"10.3390","volume":"17","author":[{"given":"Eleonora Francesca","family":"Pattonieri","sequence":"first","affiliation":[{"name":"Unit of Nephrology, Dialysis and Transplants, Fondazione I.R.C.C.S. Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1440-6872","authenticated-orcid":false,"given":"Marilena","family":"Gregorini","sequence":"additional","affiliation":[{"name":"Unit of Nephrology, Dialysis and Transplants, Fondazione I.R.C.C.S. Policlinico San Matteo, 27100 Pavia, Italy"},{"name":"Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1439-7662","authenticated-orcid":false,"given":"Maria Antonietta","family":"Grignano","sequence":"additional","affiliation":[{"name":"Unit of Nephrology, Dialysis and Transplants, Fondazione I.R.C.C.S. Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-8513-8505","authenticated-orcid":false,"given":"Tefik","family":"Islami","sequence":"additional","affiliation":[{"name":"Unit of Nephrology, Dialysis and Transplants, Fondazione I.R.C.C.S. Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gioacchino","family":"D\u2019Ambrosio","sequence":"additional","affiliation":[{"name":"Anatomic Pathology Unit, Department of Molecular Medicine, University of Pavia and Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gianluigi","family":"Ardissino","sequence":"additional","affiliation":[{"name":"Center for HUS Prevention, Control and Management, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20162 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5311-9174","authenticated-orcid":false,"given":"Teresa","family":"Rampino","sequence":"additional","affiliation":[{"name":"Unit of Nephrology, Dialysis and Transplants, Fondazione I.R.C.C.S. Policlinico San Matteo, 27100 Pavia, Italy"},{"name":"Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,2,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Smarz-Widelska, I., Grywalska, E., Morawska, I., Forma, A., Michalski, A., Mertowski, S., Hrynkiewicz, R., Nied\u017awiedzka-Rystwej, P., Korona-Glowniak, I., and Parczewski, M. (2021). Pathophysiology and Clinical Manifestations of COVID-19-Related Acute Kidney Injury-The Current State of Knowledge and Future Perspectives. Int. J. Mol. 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