Age: 51.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Small fibre neuropathy, Tachycardia, Temperature regulation disorder, Tilt table test positive, Tinnitus
Clinical narrative: Dose 1: Paresthesias developed almost immediately after injection into right delotoid along right arm with warm/cold/tingling sensations.    By day 2, I had paraesthesias radiating into axilla with a sensation of sweat without actual sweating.   The paraesthesias continued into my right face with tingling, right eye with irritation, and right ear with flushing.    I consulted with a neurologist at my place of employment.   He conducted basic blood work and EMG on right arm which were normal.   I was instructed to proceed with the second dose against my better medical judgement.    On January 19, 2021, I received the second dose in my left deltoid.   For the following 3 days, I had severe pain at the injection site radiating into my neck and upper back.  On day 4, I awoke with intense itching in right ear canal and tinnitus.  I also developed extreme abdominal pain, nausea, intense headache.   By January 30, 2021, I was having tachycardic episodes that sometimes lasted through the night, chest discomfort, and blood pressure swings with elevations as high as 200s/120s.    I went to the ER on January 30, 2021 and suggested I was having a severe reaction.  A CT showed mesenteric panniculitis.   My suggestion was dismissed, and I was sent home with ibuprofen and instructions to follow up with GI and ENT.   No explanation for the wide variety of my symptoms was given.  Through February I continued with tachycardia and blood pressure issues.  Follow up with GI included upper and lower endoscopies that were unrevealing.   Medrol dose pack was given which improved mesenteric panniculitis.  Audiogram was performed by ENT and was normal.   One ENT attributed the tinnitus to post vaccine inflammation.  Others dismissed it without further investigation (this was before tinnitus as side effect was known).    Symptoms continued to progress to include autonomic dysfunction: positional tachycardia, temperature dysregulation, intractable insomnia, adrenal dumps, brain fog. Muscle fasciculations, tremors, and skin ?zaps? continued.   The right eye irritation progressed to blurry vision and problems adjusting to light changes.  The electrical paraesthesias progressed to full blown body wide neuropathies with stinging, stabbing, burning, prickling sensations.   The cardiac dysfunction progressed to atrial fibrillation, symptomatic PVCs and NSVT.    In Sept a skin biopsy was indicative of small fiber neuropathy and tilt table was positive for POTs.   After clinic gave a presentation to Neuromuscular Department in October 2021, my neurologist (who suspected sudomotor, small fiber) decided on a trial of IVIg.   This improved the neuropathy symptom, but due to side effect of hemolysis, it was halted.   After reaching out to Dr., I was directed to Neurology for evaluation.   SCIg trial was initiated.   This continued to improve symptoms but exacerbated the tinnitus and cardiac symptoms and was halted.   As the medical profession was not actively investigating reactions and I could obtain no response from Pfizer, I took it upon myself to research my affliction.   The only labs that were revealing were autoantibody labs from overseas.  I was positive for numerous antibodies including ACE2, MAS1, AT1R, beta and muscarinic cholinergic receptors.   The validity of these results is questioned.  However, based on these findings, a trial of plasmapheresis was undertaken in March 2021.   Neuropathies resolved and POTs symptoms improved.  Tinnitus was only marginally improved.  Muscle fasciculations were reduced.   Repeat autoantibody testing post plex showed elimination and/or reduction in antibodies.    At 8 weeks, symptoms slowly returned and post plex labs were repeated showing an marked increase in autoantibodies.   Persisting symptoms include cardiac arrythmias, muscle fasciculations, paraesthesia, severe tinnitus, muscle weakness, brain fog, headache/head pressure.