Age: 11.0
Sex: F
Vaccine: MNQ, TDAP
Symptoms: Peripheral swelling, Petechiae, Protein urine present, Rash, Vomiting
Clinical narrative: hospital ruled out HSP; swelling on legs; abdominal pain; Vomiting; dehydration; wrist swelling; rash on the legs-petechiae; Initial information was received on 08-Jun-2020 regarding an unsolicited valid serious case from the physician.  This case involves an 11 years old female patient who developed HSP (henoch-schonlein purpura) with swelling on legs (peripheral swelling), abdominal pain (abdominal pain), vomiting (vomiting), dehydration (dehydration), wrist swelling (joint swelling) and rash on the legs-petechiae (petechiae), while she received vaccines DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE [ADACEL] and MENINGOCOCCAL A-C-Y-W135 (D CONJ) VACCINE [MENACTRA].  The patient's medical history, past medical treatment, vaccination and family history were not provided.  The patient's concomitant medication was not reported.  On 18-May-2020, the patient received a 0.5 ml dose of suspect DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE (lot U66502A and expiration date was not reported) via an intramuscular route in the left deltoid for prophylactic vaccination.  On 18-May-2020, the patient received a 0.5 ml dose of suspect MENINGOCOCCAL A-C-Y-W135 (D CONJ) VACCINE (lot U659694 and expiration date was not reported) via an intramuscular route in the left deltoid for prophylactic vaccination.  On an unknown date, the patient developed serious HSP (henoch-schonlein purpura) with swelling on legs (peripheral swelling), abdominal pain (abdominal pain), vomiting (vomiting), dehydration (dehydration), wrist swelling (joint swelling) and rash on the legs-petechiae (petechiae) (unknown latency) following the administration of MENINGOCOCCAL A-C-Y-W135 (D CONJ) VACCINE and DIPHTHERIA-2/TETANUS/5 AC PERTUSSIS VACCINE. These events were assessed as medically significant.  It was reported that on 21-May-2020 patient was admitted to the hospital (hospitalization) with abdominal pain, vomiting, dehydration, rash and swelling on her legs. The hospital ruled out HSP, patient was given IV fluids and discharged. Later that same day, patient went to the emergency department with complaints of wrist swelling, and rash on the legs-petechiae. The patient was then diagnosed with HSP and steroids were administered  Relevant laboratory test results included: On an unknown date, the blood pressure and protein in urine were elevated.  Final diagnosis was henoch-schonlein purpura.  Other corrective treatment was not reported.  At the time of reporting, the patient was recovering from wrist swelling. On an unknown date, the patient had recovered from abdominal pain and outcome for other events was not reported.  Patient parents are concerned that the vaccines caused this reaction.; Sender's Comments: This case concerns an 11-year-old patient who presented with Henoch-Schonlein Purpura after vaccination with MENACTRA and ADACEL. The time to onset is compatible. The laboratory data shows elevated urine protein and patient had elevated blood pressure. However, patient's medical condition at the time of vaccination were not reported. Moreover, two different vaccinations preceded the events. Based upon the reported information, the role of an individual vaccine cannot be assessed.