MALIGNANT HYPERTENSION AFTER COVD-19 VACCINE INJECTION
Journal of Hypertension
; 41:e442, 2023.
Article
in English
| EMBASE | ID: covidwho-2246139
ABSTRACT
Case;40 y/o male. Clinical course;The patient was transferred to our university hospital because of DOE and severe headache. He had been well and had no history of hypertension or obesity. He had experienced the COVID-19 vaccine injection two week before this visit. After the injection he had been experienced high fever and general fatigue as well as 7 kg of weight loss. On examnation, it was found that he had severe hypertension (190/110 mmHg) and hypertensive optic fundi. On chest X-ray, cardiomegaly and bilateral lung infiltrations was evident and biochemical data indicated renal dysfunction (serum creatinine 2.35 mg/dl), high levels of plasma renin activity (39.1 ng/ml/hour normal;0.6-3.9) and aldosterone concentration (176 pg/ml normal;4.0-82.1), and inflammatory changes (CRP = 23 mg/dl). We also found that increased levels of LDH and decreased levels of hemoglobin which indicated hemolytic anemia and thrombotic microangiopathy. After the control of high blood pressure by intravenous administration of Calcium channel blockades, We performed renal biopsy, which had a finding of diffuse findings of onion skin lesion and global glomerular sclerosis compatible with the diagnosis of malignant hypertension. Any secondary etiologies including renal artery disease or collagen disease had not been identified. Seven days after the admission, we started hemodialysis for this patient because of the renal failure was not resolved. We also had startred ACE inhibitors. We stopped the diuretics and minimized the ultrafiltration. Twenty-five days after the admission the patients was withdrawn from dialysis with the urine volume around 2000 ml/day and the serum creatinine concentration 5.29 mg/dl. He was discharged without any aid of dialysis and with small number of anti-hypertensives. Four months after the discharge, his serum creatinine concentration was 3.36 mg/dl and his blood pressure was 139/85 mmHg with the ACE inhibitor and calcium channel blockades. Conclusions;The case suggested that the malignant hypertension might be triggered by COVID-19 vaccine injection, which is of clinical importance.
aldosterone; antihypertensive agent; C reactive protein; calcium channel; dipeptidyl carboxypeptidase inhibitor; diuretic agent; endogenous compound; hemoglobin; SARS-CoV-2 vaccine; adult; blood pressure; body weight loss; cardiomegaly; clinical significance; collagen disease; conference abstract; controlled study; creatinine blood level; fatigue; fever; gene expression; glomerulosclerosis; hemodialysis; hemolytic anemia; human; human tissue; hypertension; intravenous drug administration; kidney biopsy; kidney dysfunction; kidney failure; lung infiltrate; male; malignant hypertension; nonhuman; onion; plasma renin activity; protein blood level; protein expression; renal artery; side effect; skin defect; thorax radiography; thrombotic microangiopathy; ultrafiltration; urine volume
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Collection:
Databases of international organizations
Database:
EMBASE
Topics:
Vaccines
Language:
English
Journal:
Journal of Hypertension
Year:
2023
Document Type:
Article
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