Post Rabies Vaccination Immune Dysregulation; Atypical Hemolytic Uremic Syndrome, A Case Report

Hemolytic uremic syndrome (HUS) is characterized by the triad of mechanical micro-angiopathic hemolytic anemia, thrombocytopenia and renal impairment. Atypical Hemolytic Uremic Syndrome (aHUS); non Shiga-toxin-HUS, represents 5 -10% of HUS in children and is associated with a mortality rate of 20–25% and a morbidity of 48%, since pediatric patients typically progress to end stage renal disease (ESRD)1 It’s either caused by inherited pathogenic variants in complement gene variants, which account for 50% to 60% or by autoantibodies directed against complement factor H We report the first aHUS case, confirmed by Whole Exome Sequencing (WES), following two injections of purified Vero cell culture rabies vaccine (PCEC), which was satisfactorily managed using a combination of plasma exchange (PEX) and immunosuppressive therapy. Our case highlights the possible association between aHUS and rabies vaccination in genetically susceptible individuals.