Age: 2.0
Sex: M
Vaccine: DTAP, HEP, HIBV
Symptoms: Abnormal behaviour, Alanine aminotransferase increased, Aphasia, Aspartate aminotransferase increased, Autism
Clinical narrative: The pt's attorney alleges that "beginning in approximately Sept 1999, pt began to display symptoms of neurological damage consistent with mercury poisoning, including losing his language skills, engaging in repetitive and stereotypical behaviors, suffering from diminished cognitive ability and becoming socially withdrawn. Pt has since been diagnosed as suffering from mercury poisoning and disintegrative (or 'late onset',  'degenerative' or 'regressive') autism." Onset of these symptoms reportedly occurred 9 mos following receipt of the second injection of Engerix-B when the pt was 16 mos old. According to atty, pt developed normally and demonstrated social, language, cognitive, behavioral and physical skills appropriate for his age prior to completing the schedule of thimerosal injections. Atty states pt is receiving treatment to remove mercury from his body and as the mercury levels drop, there is some improvement noted in his symptoms. He states, however, that the pt's injuries are permanent. F/U states developmental history revealed that the child had been "completely normal" according to his mother, until his 2nd birthday. Specifically, at 2 weeks of age, he was alert, startled and regarded face. At 2 months, he lifted his head, followed to midline, smiled and cooed. At 4 months, he had head control, rolled "little", put his hand to his mouth, followed 180 degrees, localized, cooed and laughed. At 6 months, he rolled, pulled himself to sit, transferred objects with his hands and vocalized. At 12 months, he pulled to a standing position, cruised, performed pincer, waved, clapped and was "Dada, Mama-specific". On 5/15/00, at 2 years of age, he climbed steps alone, 1 step at a time, scribbled, followed directions and played with a ball by rolling it back and forth. He appeared to hear well, acted on language and responded to commands. He did not point or know body parts and he did use words. The physician's recommendation was floor time with his mother, beginning with 10 minute sessions. F/U states, On 10/24/00, the mother called the physician to report that the child had been having frequent nosebleeds for the past 2 days and she was advised to increase the humidity in the home and apply petroleum jelly. The parents state that since he had been on the gluten-free and casein-free diet, they have seen astounding changes. He has better eye contact, his language has improved immensely and the applied behavioral analysis (ABA) might work. He also uses the special vitamins that were recommended at the autism conference in early 11/00, which they attended. The child was re-evaluated by the same speech/language pathologist on 12/12/00 and he continues to display language and communication behaviors that are consistent with autism. In the clinic paperwork, the parents noted the reason for referral to be "The child has been dx'd with allergy and mercury-induced autism. We want a review of all tests from a metabolic perspective. Is (his) current protocol appropriate-confirm dx". On the medical history form, under "other serious illness", the parents wrote "Hypogammaglobulinemia, Autoimmune dysfunction, Nodular hyperplasia", under "Systems review", they indicated that the child had "trouble chewing or swallowing" and "appetite is poor". They indicated that the child was not bowel trained and not dry at night and had not learned to ride a tricycle.