Age: 15.0
Sex: F
Vaccine: HPV4, VARCEL, HPV4, HPV4, VARCEL
Symptoms: Alanine aminotransferase increased, Anaemia, Arrhythmia, Aspartate aminotransferase increased, Chest pain
Clinical narrative: Information has been received from a physician concerning a 17 or 18 year old female patient who on 01-APR-2008 was vaccinated with her first dose of 0.5 ml GARDASIL (lot # 659964/1978U) at the treating physician's office. In approximately April 2008 ("after first dose"), the patient experienced idiopathic thrombocytopenic purpura (ITP) quickly and got very fatigued. Her ITP was thrombocytopenia. The patient did finish the series. The second dose was given at a different clinic and was given on 28-SEP-2009. The third dose (lot # 665266/1378Y) was given on 09-MAR-2010 at the treating physician's office. For the dose that was given in 2010 the child was given flu vaccine (manufacturer unknown) and HPV vaccine together. It was unspecified if the other doses were given with other vaccines also. Her platelet levels were going up and down. In 2009 the platelet count went down to 90. Her lowest count was 20 and it was unspecified when this count was taken. Her count went up to 114 and 113 at some points, respectively. The last checked count was at 85. The patient was referred to children's hematology. The doctor at first said that she was not convinced it was from the vaccine but hematologist said that it might have been. The patient was being followed by hematology and would be coming back next week. The patient was never hospitalized. It was not sure if the hematology department did a VAERS report. They went through her past medical history and saw nothing out of the ordinary. At the time of this report, the patient had not recovered from the events. Upon internal review, idiopathic thrombocytopenic purpura was considered to be an other important medical event. Follow up information has been received from the physician concerning the approximately 16 year old female patient (previously reported as 17 or 18 year old patient) with high insulin (08-APR-2006), high cholesterol (06-MAY-2006), obesity (31-JUL-2006), no illness at time of vaccination, who on 01-APR-2008, was vaccinated with a first dose of GARDASIL. Secondary suspect therapy included VARIVAX (Merck) (Lot # 659944/1796U) SQ. Concomitant therapy included hydrocortisone. The physician reported that on 22-SEP-2009 the patient experienced arrhythmia with exercise. On 28-SEP-2009, the patient experienced thrombocythemia. On an unspecified date the patient recovered. The physician also stated that on 16-OCT-2009 the patient experienced chest pain. On 09-MAR-2010, the patient experienced anemia syncope. On 25-MAR-2010, the patient was referred to hospital and diagnosed with thrombocythemia. On 29-MAR-2010,  platelet count was low, absolute eosinophils were low and erythrocyte sedimentation rate was high. Aspartate aminotransferase and alanine aminotransferase were high. On 02-APR-2010, the patient was diagnosed with thrombocytopenia. On 05-APR-2010, a carisbad imaging was performed and showed abdominal u/s elevated liver enzymes. At the time of the report, the patient's outcome regarding chest pain, thrombcythemia, thrombocytopenia, ALT high, anemia, arrhythmia with exercise, AST high, erythrocyte sedimentation rate high and syncope were unknown. Additional information has been requested.