Age: 3.0
Sex: M
Vaccine: VARCEL
Symptoms: Irritability, Oropharyngeal pain, Petechiae, Pharyngeal erythema, Pruritus
Clinical narrative: 3/30/2021 - VARIVAX Varicella Vaccine Administered appx 9am.  At appx 4pm (could have been sooner as he was napping for a few hours from about 1-4pm) Pinpoint red and purple dots appeared over Patient's chest and sides, as well as a few on his arms and neck.  He also complained that his stomach hurt and was more irritable than usual.  That night he fell to sleep about an hour earlier than usual.  4/1/2021 - Patient continued to be irritable and complained he was tired all day long.  He began itching and developed a rash, mainly on his sides and stomach/chest area.  Red and Purple pinpoint spots were still present from the day prior.  4/2/2021 - Most of the pinpoint spots had faded but there were still a few present; fatigue.  4/3/2021 - Pinpoint spots gone except maybe one.  Rash was better; fatigue.  4/17/2021 - I report in an email to Dad that Patient has been very fatigued and sleeping longer than usual the last couple weeks.  4/28/2021 - Patient receives dose 1 of his his IPV vaccine.  5/27/2021 - I took Patient  in for his MMR, but he had a fever of 100.7. They turned us away for vaccination due to this and said to reschedule.  I am unsure how long he had fevers prior to this because this was the first time I had been alerted that he had one since onset of symptoms.   6/10/2021 - Patient recieves his dose 1 of MMR but is examined first because he has now been having fevers for 2 weeks off and on. He also has now complained of fatigue most days since 3/30/2021.  7/8/2021 - I take Patient in for dose 2 of his DTAP but he has a low grade fever and his doctor decided it was best to get some bloodwork done to address the ongoing fevers and possible atopic immune function.  He tells us to get the bloodwork and return to office for DTAP after that.  At this appointment they also discover Patient has been having some allergy symptoms, runny nose off and on for 6 weeks, sore/red throat, and also a new symptom, trouble swallowing.  Patient reports having ?low energy? to the nurse.  also self reports his "low energy" to the nurse.  7/12/2021 - Dr. does a Telemed with Dad explaining why the bloodwork needs to be done to check the fevers and immune function, because Dad didn't want to admit there was a problem. Dr. also was emailing with us about this throughout the process and felt it was important to look into.  7/22/2021 - DTAP shot given.  8/7/2021 - Bloodowrk performed.  8/10/2021 - Abnormal Thyroid Labs recieved, reviewed by Dr. and referral to Endocrinologist is written  8/19/2021 - I take Patient in to get his HepB and Prevnar13 shots.  He has a low grade fever of 99.9, but after an exam recieved the vaccines.  Low energy, fatigue, trouble swallowing reported by Mom and Patient in the appt, as well as continued fevers off and on the last three months.  An initial diagnosis of Hyperthyroidism is given.  8/19-8/21  Patient develops a limp following his vaccines.  9/2/2021 - Consultation with Endocrinologist, Dr.  Seeing the abnormal lab results, and noting family history of autoimmunity, he ordered further labs to check for thyroid antibodies that could ascertain an autoimmune thyroid condition.  9/14/2021 - Bloodwork performed.  9/20/2021 - Telemed visit with Dr. to go over the lab results.  He notes that due to Patient being "antibody positive" and the levels they were at, he was able to confirm a Diagnosis of Hashimotos Thyroiditis.  He said that the numbers on the lab test were mimicking hyperthyroidism because Patient's body has been trying to compensate for the problem.  He said that it appears to be early in the disease so no medicine is needed yet.  However, we should watch for further and worsened fatigue or anything abnormal and consider re-testing the thyroid levels whenever it seems things are worsening so that we can further evaluate the diagnosis as his body will continue to destroy his thyroid over time.