Taurine intake ameliorates lactic acidosis and hyperferritinemia occurring after mRNA SARS-CoV-2 vaccination in a patient with β-thalassemia trait: a case report and review of literature

Abstract

Background Taurine is a powerful antioxidant necessary for mitochondrial function. Lactic acidosis is a complication encountered in the condition mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS), which can be successfully treated with supplemental taurine. Furthermore, taurine regulates the production of iron-dependent proteins such as ferritin that can act as chelating agents to sequester labile iron.

Case presentation A 38-year-old Greek male with a β-zero thalassemia trait developed multiple severe symptoms soon after his first and only mRNA (Pfizer) SARS-CoV-2 vaccination that included hematological stress to be a candidate for blood transfusion. Amongst the hematological readings, the patient had lactate levels > 4 mmol/ml, indicating lactic acidosis, and ferritin levels > 820 ng/ml, representing hyperferritinemia. Moreover, the patient has organic acid and plasma metabolite levels in the urine that are indicative of mitochondrial dysfunction. Regular taurine intake (500 mg/day) for years helped the patient control lactate and ferritin levels and avoid more serious clinical decompensation.

Conclusion Regular taurine intake helps to avoid lactic acidosis and reverse hyperferritinemia after mRNA SARS-CoV-2 vaccination in a patient with β-zero thalassemia trait with no obvious genetic trait linked to mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes. Taurine seemed to be protective for mitochondria.