Age: 53.0
Sex: F
Vaccine: RAB
Symptoms: Blood creatinine increased, Complement factor C3, Complement factor C4, Complement factor normal, Dialysis
Clinical narrative: Initial information received from  a literature abstract on 23-May-2019. This case involves a 53 years old female patient who experienced acute allergic tubulointerstitial nephritis (AIN) and severe anuric acute kidney injury (AKI), while she received vaccine RABIES VACCINE. The patient's past medical history included Sarcoidosis (she was diagnosed with it 10 years ago and renal biopsy did not show any granuloma), Polycystic ovaries, Anuria and Animal bite. The patient's past medical treatments included Augmentin (she used it 3 times in the last 4 years). The patient's past vaccination(s),family history and concomcitnat medications were not provided. On an unknown date, the patient received three doses of suspect RABIES VACCINE produced by unknown manufacturer (lot number, expiry date, dose, dose in series, route and site of administration were not reported). On an unknown date, the patient developed a serious acute allergic tubulointerstitial nephritis (tubulointerstitial nephritis) with symptoms like severe anuric AKI (renal failure) following the administration of RABIES VACCINE. The patient was hospitalized for these events. Relevant laboratory test results included: Blood creatinine increased - On an unknown date: 5.53 mg/dL Urine analysis - On an unknown date: 100 UNK [100 WBC/HPF 3 RBCs/HPF] Other relevant tests included Serologist for ANA, ANCA, hepatitis B& C, ACE, C3 and C4 were normal. U/S showed normal sized kidneys without nephrolithiasis, Serum creatinine continued to rise and dialysis was initiated. Renal biopsy showed acute allergic tubulointerstitial nephritis without any granuloma. Final diagnosis was severe anuric AKI and acute allergic tubulointerstitial nephritis. It was not reported if the patient experienced any adverse event or not. The outcome of the events was not reported. AIN is unlikely to be related to sarcoidosis since she was diagnosed with it 10 years ago and renal biopsy did not show any granuloma. AIN is unlikely to be related to Augmentin. Since the patient has completed 3 courses of anti-rabies vaccinations 7 days prior to admission, reporter speculate that her AIN could be secondary to anti-rabies vaccinations. There will be no information available on the batch number for this case. Documents held by the sender: none.; Sender's Comments: This literature case involves a 53 years old female patient who experienced acute allergic tubulointerstitial nephritis and severe anuric acute kidney injury post vaccination with RABIES VACCINE produced by unknown manufacturer. Time to onset is unknown. Patient's past medical history included Sarcoidosis. Serum creatinine continued to rise and Renal biopsy showed acute allergic tubulointerstitial nephritis without any granuloma. Other causes of tubulointerstitial nephritis like infection, reaction to other diseases and toxin needs to be rule out before a causal association can be made between the vaccine and the event. Therefore, additional information regarding patient's medical condition at the time of vaccination, concomitant medication, time to onset, etiological workup and lab test excluding other causes will be needed for complete assessment of the case. Based upon the reported information, the role of the vaccine cannot be assessed.