Age: 35.0
Sex: F
Vaccine: HEP
Symptoms: Immediate post-injection reaction
Clinical narrative: Initial and follow up information has been received concerning a case in litigation obtained from published literature articles concerning a 35 year old female with panic disorder and anxiety diagnosed in 2000, and a history of lightheadedness, dizziness, weakness, lethargy and weight loss who on 13-MAY-2002 and 12-Jun-2002 was vaccinated with a dose of RECOMBIVAX HB.  The patient reports that she was healthy before the vaccinations.  It was reported the vaccinations the patient had an inner ear disorder, mitral valve prolapse, hypothyroidism, migraine, and anxiety and was on multiple medications to treat, all of which had the potential to cause dizziness, headache, palpitations, and lightheadedness.  The patient experienced each of these symptoms prior to the vaccinations.  The patient had reported that right after her second vaccination, she experienced lightheadedness, dizziness and weakness.  The patient also experienced emotional distress.  The patient attributed her anxiety to attending dental hygienist school and guilt over leaving her six year old child to attend school.  The patient's symptoms went away when the school semester ended and she also felt better on the weekends.  Despite testing showing the patient to be neurologically normal, she was diagnosed with chronic inflammatory demyelinating polyneuropathy (CIDP) and was prescribed intravenous immunoglobulin (IVIG).  However it was also reported that two years prior to the vaccinations the patient complained or lightheadedness, dizziness and weakness.  On 12-MAR-2002, two months before she had her first vaccination, the patient saw her doctor complaining of dizziness and lethargy for one to two weeks, and a weight loss, which her physician found subjective.  It was reported that "the patient's vaccine injury lasted three to four months and that she was probably normal in the summer of 2003".  The patient indicated that the hepatitis B virus vaccine caused her to suffer demyelinating polyneuropathy.  The emotional distress lasted until 31-JUL-2007.  Additional information is not expected. This is in follow-up to report (s) previously submitted on 3/6/2009.  Initial and follow up information has been received concerning a case in litigation obtained from published literature articles concerning a 35 year old female with panic disorder and anxiety diagnosed in 2000, and a history of lightheadedness, dizziness, weakness, lethargy and weight loss who on 13-MAY-2002 and 12-Jun-2002 was vaccinated with a dose of HEPATITIS B virus vaccine rHBsAg (manufacturer unknown).  The patient reports that she was healthy before the vaccinations.  It was reported before the vaccinations the patient had an inner ear disorder, mitral valve prolapse, hypothyroidism, migraine, and anxiety and was on multiple medications to treat, all of which had the potential to cause dizziness, headache, palpitations, and lightheadedness.  The patient experienced each of these symptoms prior to the vaccinations.  The patient had reported that right after her second vaccination, she experienced lightheadedness, dizziness and weakness.  The patient also experienced emotional distress.  The patient attributed her anxiety to attending dental hygienist school and guilt over leaving her six year old child to attend school.  The patient's symptoms went away when the school semester ended and she also felt better on the weekends.  Despite testing showing the patient to be neurologically normal, she was diagnosed with chronic inflammatory demyelinating polyneuropathy and was prescribed intravenous immunoglobulin.  However it was also reported that two years prior to the vaccinations the patient complained of lightheadedness, dizziness and weakness.  On 12-Mar-2002, two months before she had her first vaccination, the patient saw her doctor complaining of dizziness and lethargy for one to two weeks, and a weight loss, which her physician found subjective.  It was reported that "the patient's vaccine injury lasted three to four months and that she was probably normal in the summer of 2003".  The patient indicated that the HEPATITIS B virus vaccine caused her to suffer demyelinating polyneuropathy.  The emotional distress lasted until 31-JUL-2007.  In follow up information it was reported by the judge to the Special Master that "a lack of fundamental fairness" in the proceedings but said in Feb 12 opinion that the patient failed to take advantage of the remand to shore up the underlying weakness of her petition.  "Although the patient might have described her medical history to various doctors in a way that suggested a temporal relationship, a careful review of the records would contradict this conclusion, "The judge said "The pattern of the patient's medical visits in the few months following the vaccine also belies the existence of an ongoing adverse reaction.  After a visit to the medical center on June 21, 2002 the patient made no medical visits for the next five weeks, until July, 2002.  A similar six week gap occurred from August 19 to October 8, 2002.  If the patient was continuing to suffer an adverse reaction from the June 12, 2002 vaccination, it was not plausible that the patient would have separate five and six week periods of not seeing a doctor.  He agreed that the patient experienced an adverse reaction to June 12, 2002 vaccine but most probably the reaction lasted only for ten days to two weeks.  The court's conclusion was supported by the physician.  The patient was denied to vaccine Act benefits by the judge for the second time saying that some of the symptoms predated her vaccination and that her reaction to the vaccine did not meet satatutory six months of duration to qualify.  No other information is not available.