Age: 1.0
Sex: F
Vaccine: HBHEPB, MMR, VARCEL
Symptoms: Arthritis, Joint swelling, Laboratory test abnormal, Rheumatoid arthritis
Clinical narrative: Information has been received from a consumer concerning her 12 month old daughter who on 4/26/02 was vaccinated with MMR II (lot 640963/1379L). Concomitant therapy included baby aspirin. The mother reported that her baby was crawling normal before and on 4/15/02 they moved and she started crawling different (not using her knees). The mother reported that her daughter's knees were swollen and warm. She reported that her daughter started to walk on 7/21/02 when she was 15 months old. The mother reported that "we seemed to think that was late." She reported that at the end of August my son jumped on her knee and she was limping on her left knee was bothering her. On 8/27/02 the mother reported that she took her to the doctor because she was really limping. On 9/3/02 the baby had an ANA test and on 9/11/02 she was diagnosed with juvenile rheumatoid arthritis. The pt's juvenile rheumatoid arthritis persisted. Upon internal review, the juvenile rheumatoid arthritis was considered to be an other important medical event (OMIC). Additional info has been received from a physician. The physician reported that the child had multiple well baby visits, was well immunized and did not have any history of any problems with previous vaccinations. He reported that the child received MMR II along with Haemophilus B  conjugate vaccine, hep B vaccine recombinant, and varicella virus vaccine live on 4/26/02. The physician reported in reviewing the child's chart that the child was seen at an urgent care center on 9/3/02 for limping. An x-ray revealed no fracture, a CRP was normal (0.8), sedimentation rate (12), blood cultures no growth, ANA positive and rheumatoid factor negative. On 9/18/02 the child was referred to a pediatric rheumatologist who reported that the child's joints were normal except the left knee, which was slightly swollen and lacked full flexion and extension of approximately 15 degrees. Naprosyn was recommended regularly twice per day and the child was to follow-up in 6 weeks. On 9/30/02 the child was seen by a pediatric opthalmologist who reported that the child's slit-lamp exam was normal and the child had no uveitis. The physician reported that he thought that there was too long of an interval between the vaccination and the onset of child's symptoms to be associated. Additional info has been requested. Additional info has been received from the child's mother. The mother reported that towards the end of May 2002 her daughter developed a high fever over 104 and experienced a bad stuffy nose. The child was prescribed antibiotics but it was reported that they did not help. She also reported that hse noticed a major limp in her daughter's walk and that she was diagnosed with juvenile rheumatoid arthritis. The mother reported that her daughter was hospitalized for these events. Additional info is requested. Additioanl info has been recieve from a physician. The physician reported that the child developed left knee arthritis on 8/15/02. He reported that the child has not recovered. The physician also reported that the child had no illness at time of vaccinations and that she had no part medical history. The physician reported that the arthritis was considered to be disabling event. No additional info is expected.