{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:59:42Z","timestamp":1760147982984,"version":"build-2065373602"},"reference-count":28,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,3,16]],"date-time":"2023-03-16T00:00:00Z","timestamp":1678924800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Hemolytic uremic syndrome (HUS) is classically described as a triad of nonimmune hemolytic anemia, thrombocytopenia, and acute kidney injury. Atypical HUS (aHUS) is a rare variant of the disease, and it accounts for 5\u201310% of the cases. It has a poor prognosis, with a mortality rate exceeding 25% and a more than 50% chance of progressing into end-stage kidney disease (ESKD). Genetic or acquired dysregulation of the alternative complement pathway is highly implicated in the pathogenesis of aHUS. Multiple triggers for aHUS have been described in the literature, including pregnancy, transplantation, vaccination, and viral infections. Herein, we report a case of a previously healthy 38-year-old male who developed microangiopathic hemolytic anemia and severe kidney impairment one week after receiving the first dose of AstraZeneca SARS-CoV-2 vaccine. A diagnosis of aHUS was made after excluding other causes of thrombotic microangiopathies. Treatment with plasma exchange, prednisone, and rituximab (375 mg\/m2) once weekly for four doses resulted in improvement of his hematological parameters. However, he progressed to ESKD.<\/jats:p>","DOI":"10.3390\/vaccines11030679","type":"journal-article","created":{"date-parts":[[2023,3,17]],"date-time":"2023-03-17T03:33:57Z","timestamp":1679024037000},"page":"679","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["End-Stage Kidney Disease Resulting from Atypical Hemolytic Uremic Syndrome after Receiving AstraZeneca SARS-CoV-2 Vaccine: A Case Report"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3376-0666","authenticated-orcid":false,"given":"Mohammed","family":"Tawhari","sequence":"first","affiliation":[{"name":"College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard Health Affairs, Riyadh 14611, Saudi Arabia"},{"name":"King Abdullah International Medical Research Centre, Ministry of the National Guard Health Affairs, Riyadh 11481, Saudi Arabia"},{"name":"Department of Medicine, Division of Nephrology, King Abdulaziz Medical City, Ministry of the National Guard Health Affairs, Riyadh 11426, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9884-5017","authenticated-orcid":false,"given":"Moustafa S.","family":"Alhamadh","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard Health Affairs, Riyadh 14611, Saudi Arabia"},{"name":"King Abdullah International Medical Research Centre, Ministry of the National Guard Health Affairs, Riyadh 11481, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abdulrahman Yousef","family":"Alhabeeb","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard Health Affairs, Riyadh 14611, Saudi Arabia"},{"name":"King Abdullah International Medical Research Centre, Ministry of the National Guard Health Affairs, Riyadh 11481, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ziyad","family":"Almudayfir","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of the National Guard Health Affairs, Riyadh 14611, Saudi Arabia"},{"name":"King Abdullah International Medical Research Centre, Ministry of the National Guard Health Affairs, Riyadh 11481, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mansoor","family":"Radwi","sequence":"additional","affiliation":[{"name":"Department of Hematology, College of Medicine, University of Jeddah, Jeddah 23218, Saudi Arabia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1046\/j.1523-1755.2001.060003831.x","article-title":"Thrombotic microangiopathy, hemolytic uremic syndrome, and thrombotic thrombocytopenic purpura","volume":"60","author":"Ruggenenti","year":"2001","journal-title":"Kidney Int."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1681\/ASN.V961126","article-title":"The pathogenesis and treatment of hemolytic uremic syndrome","volume":"9","author":"Kaplan","year":"1998","journal-title":"J. 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