Age: 17.0
Sex: F
Vaccine: HEP
Symptoms: Myalgia, Nausea, Paralysis, Pyrexia
Clinical narrative: Information has been received from a health care professional concerning her 17-year old Caucasian sister who on 14-AUG-2001 at 4:00 pm was vaccinated IM in the right deltoid with a third dose of Hepatitis b vaccine recombinant (yeast) (lot # 530712/1960J) There was no illness at the time of vaccination It was reported that the first two doses of hepatitis B vaccine recombinant (ENERGIX B) were given on 25-SEP-1999 and 25-Oct-1999, respectively. by 5:30 pm on 14-Aug-2001, the patient experienced nausea and fatigue. The next day on 15-AUG-2001, the patient developed chills, fever, muscle pain, shortness of breath, constriction of her chest, a headache and diaphoresis. On 16-Aug-2001, it was reported that the patient was still experiencing muscle cramps and chest discomfort. The patient sought medical attention and was placed on Prenisone 5 mg. As of  21-AUG-2001, it was reported that the patient was still experiencing some chest discomfort and that it was a "sharp pain in the breast bone area", not a prolonged pain.  Follow-up information from the physician on13-Sep-2001 indicated that the patient was still experiencing muscle cramps and tightness in her chest. He reported that the patient experienced leg paralysis when she was vaccinated with measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live *second generation) years ago (WAES0100181)  Follow-up information from a health professional indicated that the patient's chills, fever and headache have resolved, But her myalgia (especially in the legs, hands and feet) and her chest discomfort persist. On 19-SEP-20001, she had a reactive ANA. The ANA titer was 1:80, the ANA pattern was speckled, the RA factor was <20 and her Lyme was 017. She has rheumatology consult pending.  Follow-up information has been received from a physician indicating that the patient still has some problems with her leg paralysis and that he recently did an ANA blood test that was 1:8. He feels that the patient may have some type of rheumatoid problem and he is referring her to a rheumatologist.  Follow-up information has been received from a health professional indicating that the patient still have myalgia especially in the right hip and abdomen she also continues to have right sided headaches and right sided facial pain. it was reported that she has had a cardiology consult with an echocardiogram done (results not reported) and a rhumatolgy consult with labwork done. It was noted that the patient had missed multiple days from school due to the pain and is unable to participate in physical education She has not yet recovered  Upon internal review, the patient's shortness of breath and constriction of the consideration to be other important medical events. Follow up on 03/09/04: "Additional follow up information from a LPN described the pt's myalgia as multiple site (hip, face, chest). The reporter indicated that the pt is still unable to fully participate in physical education class due to fatigue upon exertion. The pt continues to have multiple school absences due to complications.  It was noted that the pt has had multiple MD visits included neurology consults, rheumatology consults and cardiology consults. At the time of the report, the pt had not recovered from myalgia, headahce and fatigue.  Upon internal review the pt's shortness of breath and constriction of the chest were considered to be other important medical events (OMIC).  Additional information has been requested."