Age: 36.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Fatigue, Flank pain, Hydronephrosis, Ovarian cyst, Pyelonephritis
Clinical narrative: right kidney is significantly atrophic and poorly functioning/Complete loss of right kidney volume; right kidney is significantly atrophic and poorly functioning; low-grade fever; fatigue; right-side flank pain/frequent flank pain on the right upper quadrant abdomen area; low energy; A left ovarian cyst measuring up to 2.0 x 1.6 cm; The stomach is partially distended without visible wall thickening; Left kidney mild hydronephrosis; bouts of pyelonephritis; This is a spontaneous report received from contactable reporter(s) (Consumer or other non HCP), Program ID. The reporter is the patient.  A 36-year-old female patient (pregnant) received bnt162b2, bnt162b2 omi ba.4-5 (BNT162B2, BNT162B2 OMI BA.4-5), on 22Dec2022 as dose 4 (booster), 0.3 ml single (Lot number: GJ3274) at the age of 36 years intramuscular, in left deltoid for covid-19 immunisation. The patient's relevant medical history included: "two pregnancies", start date: 2011 (unspecified if ongoing), notes: two pregnancies during 2011-2012 and 2015-2016; "typhoid", start date: 2010 (unspecified if ongoing), notes: typhoid diagnosis in 2010. There were no concomitant medications. Vaccination history included: bnt162b2 (DOSE 1, SINGLE, Anatomical site of Injection: Left Arm, Route of administration: Intramuscular, Batch/Lot number: ER2613), administration date: 19Mar2021, for COVID-19 immunisation; bnt162b2 (DOSE 2, SINGLE, Anatomical site of Injection: Left Deltoid, Route of administration: Intramuscular, Batch/Lot number: EW0158, Dose: 0.3 mL), administration date: 09Apr2021, for COVID-19 immunisation, reaction(s): "flank pain"; bnt162b2 (DOSE 3 (BOOSTER), SINGLE, Anatomical site of Injection: Left Deltoid, Route of administration: Intramuscular, Batch/Lot number: FJ8757, Dose: 0.3 mL), administration date: 10Dec2021, for COVID-19 immunisation, reaction(s): "fatigue after the third (first Booster) vaccine", "frequent flank pain on the right upper quadrant abdomen area for several months", "And within 8 months I came to know that my right kidney has no use", "I came to know my right kidney is significantly atrophic", "suddenly due to my right side abdominal pain", "I never had any flank pain before early 2022. It started after my second Pfizer vaccine for COVID19 and became severe". The following information was reported: PYELONEPHRITIS (disability) with onset 23Feb2023 at 13:40, outcome "not recovered", described as "bouts of pyelonephritis"; HYDRONEPHROSIS (disability) with onset 04May2023 at 10:19, outcome "not recovered", described as "Left kidney mild hydronephrosis"; OVARIAN CYST (disability) with onset 01Jun2023 at 16:08, outcome "not recovered", described as "A left ovarian cyst measuring up to 2.0 x 1.6 cm"; ABDOMINAL DISTENSION (disability) with onset 01Jun2023 at 16:08, outcome "not recovered", described as "The stomach is partially distended without visible wall thickening"; RENAL ATROPHY (disability, medically significant), outcome "not recovered", described as "right kidney is significantly atrophic and poorly functioning/Complete loss of right kidney volume"; RENAL IMPAIRMENT (disability, medically significant), outcome "not recovered", described as "right kidney is significantly atrophic and poorly functioning"; PYREXIA (disability), outcome "not recovered", described as "low-grade fever"; FATIGUE (disability), outcome "not recovered"; FLANK PAIN (disability), outcome "not recovered", described as "right-side flank pain/frequent flank pain on the right upper quadrant abdomen area"; ASTHENIA (disability), outcome "not recovered", described as "low energy". The events "bouts of pyelonephritis", "left kidney mild hydronephrosis", "right kidney is significantly atrophic and poorly functioning/complete loss of right kidney volume", "right kidney is significantly atrophic and poorly functioning", "low-grade fever", "fatigue", "right-side flank pain/frequent flank pain on the right upper quadrant abdomen area" and "low energy" required physician office visit. The patient underwent the following laboratory tests and procedures: Angiogram: (unspecified date) Atrophic right kidney, notes: Patent arterial vasculature of the abdomen without evidence of occlusion, high-grade stenosis, aneurysm, or dissection. Atrophic right kidney with patent single right renal artery, which is correspondingly smaller than the left renal artery; (01Jun2023) The right kidney is significantly atrophic, notes: 04:08 PM Findings: Vascular: Abdominal aorta of normal caliber. Celiac, superior mesenteric inferior mesenteric arteries patent. Bilateral renal arteries patent. No accessory renal arteries present. Right renal artery smaller than left. Iliofemoral vessels normal caliber. No significant atherosclerotic disease present. Nonvascular: Lung Bases: no consolidation. Liver: normal in size. No solid hepatic masses. Gallbladder/Biliary System: normal, no signs of acute cholecystitis, No bile duct dilation seen. Spleen: unremarkable, Pancreas: homogeneous with no duct dilation, Adrenals: grossly unremarkable, Kidney/Ureters/Bladder: right kidney significantly atrophic. left kidney normal in size. no evidence of nephrolithiasis or hydronephrosis. ureters are normal caliber. Partially visualized urinary bladder wall not thickened. Reproductive Organs: Uterus partially visualized. A left ovarian cyst measuring up to 2.0 x 1.6 cm also partially visualized. Stomach: partially distended without visible wall thickening. Bowel: Visualized portions of bowel demonstrate no evidence of obstruction or bowel wall thickening. Vasculature: Hepatic and portal veins patent. Lymph Nodes: No suspicious lymph nodes seen throughout abdomen. Peritoneal Cavity: No free fluid or free air seen within abdomen. Soft Tissues: abdominal wall unremarkable with no significant hernias detected. Bones: Vertebral body height and alignment maintained; Body temperature: (unspecified date) low-grade fever; Computerised tomogram abdomen: (2010) unknown results; (16Jul2010) terminal ileum dilated and fluid-filled, notes: Indication: Abdomen pain and enterocolitis. Bowel wall thickening involving the right hemicolon has resolved since the last examination. The terminal ileum remains somewhat dilated and fluid-filled. There is no localized abscess collection or free fluid in the pelvis. The patient states that the appendix is absent. No bowel obstruction is present. No mass or lymphadenopathy has developed since the last exam. The lung bases are clear; Renal scan: (01Jun2023) Abnormal perfusion, function, Lasix response, notes: of kidneys. 01:49 PM Abnormal perfusion, function and Lasix response of the kidneys. Right kidney is significantly smaller than the left. Radionuclide: Following intravenous administration of 11.2 mCi 99mTc MAG3, a dynamic renal scintigraphy study performed. Routine imaging obtained. 20mg of intravenous Lasix utilized for diuresis portion of exam. Findings: Split renal function calculation asymmetric (86.4% on left,13.6% on right). This is due to significant discrepancy in size of kidneys. There is prompt flow of radiotracer to bilateral kidneys, with normal accumulation seen in renal cortex. Prompt excretion of radiotracer is seen bilaterally as well. There is adequate response of both kidneys to the administration of Lasix, as evidenced by a normal T-1/2 of 1.0 minutes on the left and 1.8 minutes on right; Scan: (01Jun2023) unknown results, notes: at 02:49 PM and 04:08 PM; Ultrasound kidney: (23Feb2023) Pyelonephritis and Atrophy of right kidney, notes: At 1:40 PM Atrophic right kidney with cortical thinning which may be due to prior bouts of pyelonephritis. No hydronephrosis or renal calculi. Findings: The right kidney measures 7.3 x 3.4 cm and the left kidney measures 11.7 x 6.0 cm. The left kidney demonstrates normal parenchymal thickness and echogenicity. The right kidney is atrophic with moderate cortical thinning. No suspicious lesions are depicted. No hydronephrosis or calculi. Color Doppler demonstrates intact parenchymal blood flow. The bladder has a calculated volume of 95 cc; (04May2023) Atrophic Rt kidney, Lt kidney mild hydronephrosis, notes: At 10:19 Atrophic right kidney without hydronephrosis. Previous identified echogenic lesion in the right kidney is not identified on this exam. 2. Left kidney is stable in size and appearance with dilatation of the renal pelvis similar to prior exam. Rt Kidney: below normal in size measuring 6.8 cm in length. Cortical medullary differentiation maintained. No hydronephrosis identified. Vascular flow to kidney seen. Previously seen echogenic focus involving right kidney not identified on this exam. Lt Kidney: normal in size measuring 11.4 cm in length. Renal cortical echogenicity and parenchymal thickness within normal limits. Vascular flow to kidney identified. The fullness of renal pelvis similar prior exam and may represent mild hydronephrosis. No echogenic shadowing stones seen; (11Aug2023) Rt kidney Atrophic and left renal pelvic fullness, notes: at 09:45 AM Rt kidney measures 6.9 x 2.9 cm. Corticomedullary differentiation preserved. No discrete mass, calculus, hydronephrosis or perinephric fluid seen. Doppler confirms blood flow to right kidney. left kidney measures 11.7 x 5.4 cm. Corticomedullary differentiation preserved. No discrete mass, calculus, or perinephric fluid. There is left pelvic fullness without overt hydronephrosis. Doppler confirms blood flow to left kidney. Urinary bladder decompressed a calculated volume of 11 cc, limiting evaluation of urinary bladder wall. Atrophic right kidney and left renal pelvic fullness. No hydronephrosis bilaterally. Decompressed urinary bladder. Therapeutic measures were taken as a result of pyelonephritis. Clinical Course: She had a BS degree in Computer Science and Engineering, and an MS degree in Information Technology (software track) from the (Institution Name Withheld). She moved from (City and State Withheld) to (City and State Withheld) in 2015 with her husband, (Name Withheld), PhD who was a tenured Associate Professor of Civil and Environmental Engineering at (university and state name). She was healthy and had no organ-related health issues prior to her COVID-19 vaccinations from Pfizer in 2021. Meanwhile, on 02Nov2022, she went to her yearly complete physical checkup and informed the doctor about having a frequent flank pain on right upper quadrant abdomen area for several months. Following doctor's suggestions, she then did an ultrasound for her upper right quadrant abdomen area. Based on report, she came to know from doctor that she had a significantly atrophic right kidney. She was shocked since she had heard the news for the first time in her life, despite having done many full abdominal ultrasounds and CT scans for other purposes (e.g., typhoid diagnosis in 2010, as well as two pregnancies during 2011-2012 and 2015-2016). The primary care doctor referred her to a Specialist Urologist soon. She was able to find an appointment with urologist as early as 06Mar2023. Subject to continuous flank pain and fever, she went to primary care again and did another ultrasound on 23Feb2023. Based on report, her doctor commented, "Her kidney ultrasound continued to show that her right kidney was very small." Her right kidney was measured to have dimensions of 7.3 cm x 3.4 cm at that time. She went to urologist and did another ultrasound on 04May2023. The result showed a shrinking right kidney, stating, "The right kidney was below normal in size measuring 6.8 cm in length." She was having severe and continuous symptoms such low-grade fever, fatigue, and right-side flank pain. She contacted her urologist again. Following suggestions from the urologist, I did a Nuclear Renal Scan and a CT Angio Abdomen on 01Jun2023. The CT Angio report "Atrophic right kidney with patent single right renal artery, which was correspondingly smaller than left renal artery." On a follow-up visit, her urologist explained, right kidney was significantly atrophic and poorly functioning; however, it was not obstructed and cannot improve its function. She was a mother of two kids (11years and 7 years). Both the delivery was normal, and the pregnancy period was also normal. She did many ultrasounds during her pregnancy time. She never had any issues at that time. She had no previous kidney injury. Now her life had become severely limited with a potentially uncertain and compromised future. She must survive with one kidney, which was a disability and a new dimension added to her life. She felt fatigued with low energy, which was significantly obstructing her daily life. Her life had become limited in so many ways. She was not able to stand for long, lift normal weights, or vacuum her house. Her dream career and job prospect had been significantly compromised by atrophic kidney and associated symptoms after taking the Pfizer vaccines. Her health had been severely damaged due to loss of a critical and vital organ. Her life expectancy had likely been significantly reduced by vaccines. She was extremely worried about herself, her underaged kids and her family. To save her remaining kidney, she must go through regular ultrasounds (and CT scan), lab works, and doctor's appointments (every 6 month). She was very concerned about her left kidney, which had been making up for lost function of her damaged right kidney. She was afraid that she may require a kidney transplant in the foreseeable future. She therefore requested Pfizer to provide her with a significant compensation for her lost kidney, continuous physical and mental sufferings, obstructed daily life and reduced life-expectancy, potential treatments, loss of career in a highly demanding field, and uncertain future for herself and her family, including her two underaged kids. Comments From the Doctor's Office: Her kidney ultrasound continued to show that her right kidney was very small. There were some changes in the kidney likely due to kidney infections that had. Otherwise the anatomy appears normal - no obvious reason for these kidney infections. The kidney also had good blood flow which was a good sign. CT. ABD Pelvis With Contrast: 16Jul2010 15:32: Technique: Limited images through lung bases demonstrate no pleural or pericardial effusions. Heart size was normal. No focal areas of consolidation or mass were present. Since last examination, the bowel wall thickening involving right hemicolon had resolved. Thickening of terminal ileum had improved, although it was still somewhat dilated and remains fluid-filled. No localized abscess formation was present. No bowel obstruction had developed. No enlarged lymph nodes had developed within abdomen or pelvis since examination. Kidneys were not obstructed. Spleen was not enlarged. There were no CT changes of pancreatitis. Changes compatible with focal fatty infiltration of liver near the falciform ligament were stable. Bladder outline was unremarkable. No adnexal masses were present. Ischiorectal fossa was unremarkable. Bone windows demonstrate no abnormalities. CT Angio Abdomen W IV Contrast on 01Jun2023 04:08 PM: Technique: Axial images from lung bases through upper thighs followed by intravenous administration of nonionic contrast, with additional multiplanar images in early arterial and venous phases. Arterial coronal and sagittal reformats utilize MIP reconstruction techniques. Patient pregnant: Possibly (Pregnancy test needed).; Sender's Comments: Linked Report(s) : US-PFIZER INC-PV202300135086 same patient/product, different dose (dose 3)/event;