Amanda L Isaacson v. HHS - Influenza, acute proliferative crescentic glomerulonephritis, also known as rapidly progressive glomerulonephritis (“RPGN”) (2020)

Amanda Isaacson, a 26-year-old adult, received an influenza vaccine on November 3, 2011. Five days later, she presented with symptoms of fever, headache, and body aches, which progressed to renal failure with hematuria.

A kidney biopsy revealed acute crescentic glomerulonephritis, also known as rapidly progressive glomerulonephritis (RPGN) with monoclonal IgG deposits. Her treating nephrologist, Dr.

Carey, opined that the flu vaccine triggered her condition. Petitioner's expert, Dr.

Kielstein, proposed a medical theory that the flu vaccine's viral RNA can trigger an immune response, leading to RPGN/PGNMID, citing molecular mimicry and other vaccine-associated renal disorders. Respondent's expert, Dr.

Kaplan, argued that Ms. Isaacson had a pre-existing, chronic, silent kidney disease, evidenced by biopsy findings of sclerosis and a subsequent relapse, and that the vaccine was merely coincidental.

The Special Master found that Ms. Isaacson presented a sound medical theory connecting the flu vaccine to her RPGN/PGNMID, supported by her treating physicians and expert testimony.

The court determined that the temporal relationship between the vaccination and the onset of symptoms (3-5 days) was medically acceptable. While acknowledging the lack of direct literature linking flu vaccines to RPGN/PGNMID, the court found Dr.

Kielstein's theory persuasive and noted that Dr. Kaplan could not definitively rule out the vaccine's role.

The court concluded that the evidence supported an acute onset of RPGN/PGNMID following the vaccination and that respondent failed to prove an alternative cause. Therefore, entitlement to compensation was granted, and the case was to proceed to damages.