Age: 1.0
Sex: F
Vaccine: HBHEPB, MMR, VARCEL
Symptoms: Albumin globulin ratio abnormal, Allergy test negative, Alopecia, Blood alkaline phosphatase increased, Blood immunoglobulin G decreased
Clinical narrative: On 12-19-06, my boy/girl twins rec'd the MMR, HIB, Hep B and Varicella vaccinations. The twins should not have had the shots since they were both recovering from colds but the Dr. never told us that. My husband & I refused the MMR shot several times while in the office but we were intimidated by the Dr. & his staff to give it. My daughter immediately developed flu-like symptoms, a full body rash including her vaginal and anal areas, and she lost ALL of her [full head] hair over the next 4 days. She lost speech and communication including up to 15 words she had learned. She became catatonic & non-responsive to verbal & physical cues. Daughter was referred to several Dermatologists (for hair loss) & an Immunologist/Allergist. Dr. concurred with other Dr. diagnosis of Hypogammaglobulinemia for daughter. Daughter's blood work with Dr. showed weak Immuno development including very low counts of fighter B & T cells. Daughter has only shown improvement in strengthening her Immune System after seeing a Holistic Dr. starting in June 2007. This Dr. has placed her on a wheat-free, gluten-free, dairy-free diet including holistic vitamins & probiotics. To this day, daughter continues to break out in body rashes, has continual anal & vaginal rashes & her hair has not yet grown back fully. Daughter is developing physically, in speech & cognitive learning at the normal level for her age. She has met all of her major milestones. She is still under the care of her Holistic Physician to continue to build her Immune System.  5/22/08 MR received from PCP from birth to 2/5/08. Infant presented for 12mon WCC on 12/19/2006 with Assessment:  12mon healthy baby girl who is thriving very well. Developmentally appropriate for age.  No parental concerns. 8-10 word vocab. PE WNL. Vax given. Returned 12/29/06 with c/o hair loss x 2 weeks. DX:  alopecia areata.  Referred to derm. Seen again 12/30/06 with c/o rashes of the head and neck.  DX:  Skin rashes, positive, allergic vs viral rashes. 15 mon WCC 3/20/07 with Assessment R OM. WCC.  No parental concerns. 3-6 word vocab. 1/21/2010 Patient's immune system is still rebuilding. She continues to see a holistic doctor on a monthly basis when she eats certain foods (Gluto, corn, some dairy, sugar) she still breaks out in a body rash. Her vaginal/anal rash has stoll not end gone away. Most of her hair has grown back except her left eyebrow. She is still slightly delayed in overall cognition and learning but not t the degree that she needs therapy. Patient easily gets cold and flu and is prone to illness as her immune system was compromised by her vaccinations.  Seen 7/24/07 with c/o rash all over. DX: Roseola. OV 8/30/07 Eczema resolving. Assessment: Hypogammaglobulinemia for eval. Immunology Eval 8/16/07 for alopecia, eczema, and bumps on the face/trunk. Mother reports "catatonic state", unlikely r/t vaccines.  PE WNL except for alopecia of head.   DX:  Likely transient hypogammaglobulinemia of infancy 2 yr WCC. Developmentally, speaking in 2 word sentences. No parental, social or school concerns. Assessment:  Well child exam.  Alopecia