Age: 73.0
Sex: M
Vaccine: FLUX
Symptoms: Alanine aminotransferase increased, Alpha-1 anti-trypsin, Alpha-2 macroglobulin, Anti-thyroid antibody negative, Anti-transglutaminase antibody negative
Clinical narrative: Hypertransaminasaemia; This case was received as a courtesy case received from Pfizer concerning a patient for suspect drug: influenza vaccine.  Initial information received on 27-Oct-2023 and live follow up received on 30-Oct-2023 were processed together  regarding an unsolicited valid non-serious case received from a physician.  This case involves a 73 years old male patient who had hypertransaminasaemia after receiving influenza vaccine.  The patient's past medical history included COVID-19 from 26-MAY-2022 to 02-JUN-2022 with with 2 negative polymerase chain reaction (PCR) test results on 02Jun2022 and Alcohol use with Once traveled for an cruise in May2022. The patient's past medical treatment(s), vaccination(s) and family history were not provided. At the time of the event, the patient had ongoing Hyperlipidemia in JAN-1995 and Joint pain in 2010 with start date: 2010 (ongoing)..  Concomitant medications included tozinameran (pfizer biontech covid-19 vaccine) for immunisation; atorvastatin (atorvastatin) for hyperlipidaemia; and chondroitin sulfate, glucosamine sulfate (glucosamine chondroitin [chondroitin sulfate;glucosamine sulfate]) for Arthralgia.  On 14-Nov-2022, the patient received a dose 1of suspect influenza vaccine produced by unknown manufacturer lot number not reported via intramuscular route in the left deltoid for Antiviral prophylaxis (strength, formulation, batch number and expiry date: unknown). There will be no information available on the batch number for this case  On 01-Oct-2023 the patient had hypertransaminasaemia (latency 10 months 18 days).  Relevant laboratory test results included: Alanine aminotransferase (9 - 46 iU/L) - On 13-Jul-2022: 20 iU/L; on 10-Jan-2023: 218 iU/L; on 07-Feb-2023: 138 iU/L; on 23-Feb-2023: 105 iU/L; on 11-Apr-2023: 92 iU/L; on 15-Jun-2023: 114 iU/L; on 02-Aug-2023: 104 iU/L Alpha-1 anti-trypsin - On 15-Jun-2023:  [90% of normal individuals have the MM phenotype] Alpha-2 macroglobulin - On 02-Aug-2023: 159 mg/dL Anti-thyroid antibody - On 15-Jun-2023: Negative [less or equal to 20.0 U Negative, 20.1-24.9 U Equivocal equal or greater than 25.0 Positive] Anti-transglutaminase antibody - On 15-Jun-2023:  [less than 15.0 U/ml Antibody Not Detected, greater than or equal to 15.0 U/ml U/ml Antibody Detected] Antimitochondrial antibody - On 15-Jun-2023: Negative [less or equal to 20.0 U Negative, 20.1-24.9 U Equivocal equal or greater than 25.0 Positive] Antinuclear antibody - On 15-Jun-2023: Negative Apolipoprotein A-I (94 - 176 mg/dL) - On 02-Aug-2023: 151 mg/dL Aspartate aminotransferase (10 - 35 iU/L) - On 13-Jul-2022: 18 iU/L; on 10-Jan-2023: 114 iU/L; on 07-Feb-2023: 74 iU/L; on 23-Feb-2023: 59 iU/L; on 11-Apr-2023: 59 iU/L; on 15-Jun-2023: 71 iU/L Bilirubin conjugated - On 07-Feb-2023: 0.2 mg/d [Range: less than or equal to 0.2 mg/dL]; on 23-Feb-2023: 0.2 mg/d; on 11-Apr-2023: 0.2 mg/d; on 02-Aug-2023: 0.2 mg/d; on 14-Sep-2023: 0.6 mg/d Blood alkaline phosphatase (35 - 144 iU/L) - On 13-Jul-2022: 54 iU/L; on 10-Jan-2023: 71 iU/L; on 07-Feb-2023: 72 iU/L; on 23-Feb-2023: 66 iU/L; on 11-Apr-2023: 64 iU/L; on 15-Jun-2023: 72 iU/L; on 02-Aug-2023: 69 iU/L; on 14-Sep-2023: 71 iU/L Blood bilirubin (0.2 - 1.2 mg/dL) - On 13-Jul-2022: 0.7 mg/dL; on 10-Jan-2023: 0.7 mg/dL; on 07-Feb-2023: 0.6 mg/dL; on 23-Feb-2023: 0.8 mg/dL; on 11-Apr-2023: 0.8 mg/dL; on 15-Jun-2023: 0.6 mg/dL; on 02-Aug-2023: 0.9 mg/dL; on 14-Sep-2023: 0.8 mg/dL Blood immunoglobulin A (70 - 320 mg/dL) - On 15-Jun-2023: 116 mg/dL Blood immunoglobulin G (600 - 1540 mg/dL) - On 15-Jun-2023: 1157 mg/dL Ceruloplasmin (18 - 36 mg/dL) - On 15-Jun-2023: 27 mg/dL Gamma-glutamyltransferase (3 - 70 iU/L) - On 02-Aug-2023: 50 iU/L Hepatitis A antibody - On 15-Jun-2023:  [Non-Reactive] Hepatitis B core antibody - On 23-Feb-2023:  [normal range: non-Reactive] Hepatitis B surface antigen - On 23-Feb-2023:  [normal range: non-Reactive] Hepatitis C antibody - On 23-Feb-2023:  [normal range: non-Reactive] Hepatitis E antibody - On 15-Jun-2023:  [not detected] Metabolic function test - On 02-Aug-2023:  [Alkaline Phosphatase- 69 Ref Range: 35-144 U/L, AST- 66 H Ref Range: 10-35 U/L, ALT- 100 H Ref Range: 9-46 U/L, Impression on Labs: Stable] Polymerase chain reaction - On 02-Jun-2023: Negative; on 08-Jun-2023: Negative Smooth muscle antibody - On 15-Jun-2023: Negative Transient elastography - On 19-Oct-2023:  [results pending] Ultrasound biliary tract - On 24-Feb-2023:  [Impression: No acute abnormality is appreciated on this sonographic examination of the abdomen] Ultrasound liver - On 24-Feb-2023:  [Impression: No acute abnormality is appreciated on this sonographic examination of the abdomen]  Action taken: not applicable.  It was not reported if the patient received a corrective treatment for the event (Hypertransaminasaemia).  At time of reporting, the outcome was Unknown for the event hypertransaminasaemia.