Age: 49.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Cough, Dysphagia, Eating disorder, Endocrine ophthalmopathy, Eyelid ptosis
Clinical narrative: Thyroid storm; Thyroid eye disease; Graves' disease; Trouble swallowing and eating; Trouble swallowing and eating; Throat is scratchy; mild symmetric ptosis; bilateral perinasal sinus disease/nasal problems like sneezing, running nose, and coughing; nasal problems like sneezing, running nose, and coughing; trouble sleeping; This is a spontaneous report from a contactable consumer reported for herself. This 50-years-old female patient received second dose of BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE) at age of 49 years old on 06Apr2021 at around 16:50 in the top of her right arm (lot: ER8737) at single dose for COVID-19 immunisation (reported as to protect herself and others).   Medical history included ruptured brain aneurysm, it was paraopthalmic from 12Sep2012, HELLP syndrome from 01Sep2012, allergies. Seasonal allergies. Mumps, chicken pox, tetanus, rubella, measles from 1989. She had a ruptured brain aneurysm on 12Sep2012. It was a direct result from pregnancy HELLP syndrome, like toxemia on steroids. On 27Aug2012 her daughter was born, then she was diagnosed with HELLP 5 days later. She was hospitalized for another week. She was released and on 12Sep2012 and had the ruptured brain aneurysm which they say in itself was hereditary, and her blood pressure went up so high that it burst. She was hospitalized for 40 days. She was paralyzed and everything. She went on physical therapy and got everything back, no deficits.  Family history included hereditary in her family to have hyperthyroidism/thyroid problems on both sides (her father and mother). Concomitant medications included cetirizine hydrochloride for allergies, it was the generic antihistamine for Zyrtec. She had been taking them for about 20 years.  The patient previously received first dose of BNT162B2 at age of 49 years old on 19Mar2021 in the top of her right arm (lot: ERU6208) for COVID-19 immunisation.  The patient had an emergency reaction to the second dose of the Covid-19 vaccine. All events required a visit to Emergency Room and Physician Office, and received treatment.  She walking into the ER with trouble breathing and swelling to her face after the second Covid shot.  She had the second vaccine on 06Apr2021 at around 16:30, and everything went fine. She came home and felt fine. She went to bed that evening at around 23:00. She woke up on 07Apr2021 the morning at around 05:00 and was having excessively rapid heart rate, which is called tachycardia. Her left eye swelled open, and her right eye swelled shut. She took herself to the emergency room. She said that she had a hard time seeing now and had vision loss, and they gave her Iohexol intravenously. They also gave her ketorolac and methylprednisolone sodium succinate. The first one, Iohexol, they told her was iohexol (OMNIPAQUE) for a cerebral CT. They did an orbital CT with contrast. Her vitals were blood pressure 171/86, temperature 98.1, pulse 125, respirations 18, and oxygen saturation 97%. 9 years ago she had a ruptured brain aneurysm, it was paraopthalmic. She thought maybe the vaccine caused some type of brain bleed (Apr2021) because her eye was swelled out. That was the reason for the scan. After she left the ER, they sent her to an emergency ophthalmic appointment, and the ophthalmologist told her that she had to get glasses immediately. She had just had her eyes checked in February. Her vision in her left eye had deteriorated. She had to go and get glasses. Then they sent her to have thyroid lab work done. She had an appointment set up to be seen by her regular ophthalmologist that following Monday. Everything was on Wednesday, 07Apr2021. She was fine until Friday, drove to work and when she got to work at about 08:00 or 09:00 her body started shaking excessively. It was the tachycardia. She thought it was from the pain in her eye and took paracetamol (TYLENOL) but she still didn't feel well. On Monday she saw the regular ophthalmologist and he said that her neck was swollen with a goiter and she had thyroid eye disease and Grave's disease on 07Apr2021. He sent her to her primary care physician within an hour and he concluded the same thing. He immediately sent her to the pharmacy for a heart medication for tachycardia. It was propranolol (INDERAL) 20 mg, and she took it 3 times a day. He set her up with an emergency endocrinologist appointment and he spoke with the endocrinologist on Monday night and went over the charts with her. Everything that he diagnosed her with is at his office. He sent her to the endocrinologist for a final diagnosis. She went to the endocrinologist on Tuesday and she sent her for more lab work. They did a whole panel of labs. She definitely had Grave's disease with a goiter. They put her on methimazole 10 mg tablets, and she took them 2 times a day. That was only temporary until her labs come back. On Monday afternoon her primary doctor sent her to have an ultrasound of her neck. Her neck was swollen and she was having trouble swallowing and eating on 07Apr2021. The radiologist report said that it was strictly thyroid and she had no polyps or lesions. Her doctor suspected, they don't know exactly, but they suspect this happened because it was hereditary in her family to have hyperthyroidism/thyroid problems on both sides, and it was dormant and when she got the vaccine it triggered it to activate. She had thyroid storm (on 07Apr2021), and if she had not gone to the ER it could have been fatal. They were able to see everything during the thyroid storm so they could treat it. She was in thyroid crisis and had thyroid eye disease. Her left eye is permanently disfigured. She has an extremely protruding left eye and a right lazy eye. She had to see an ocular plastic surgeon to get it fixed at some point.  She lost so much weight this past week (Apr2021). She had lost 8 pounds since Sunday, and she didn't know how many before that. It hit her hard. Her adrenaline was going so fast. Her throat was scratchy (on 07Apr2021), and she had a lot of nasal problems like sneezing, running nose, and coughing (Apr2021).  It was reported that even with medicine, it only kept her heart rate down for a little while.  She didn't take Tylenol until Friday morning for eye pain. It wasn't from the pain though, it was from tachycardia.  She can close her left eye but she had damaged muscles behind her eye in Apr2021. It was still protruding, but the swelling went down about 80% 2 days after leaving the hospital. Within 24 hours after they injected her eye the swelling went down 80%, but it was still protruding. Her right eye was a lazy eye. It was swollen shut. She couldn't get it moving, so it may have been out of fear. She put cold compresses on her eyes before she went to the hospital. She was able to open her right eye. She can close her left eye but not all the way. She had to keep using eye drops because it got dry (in Apr2021). Her vision has gotten worse since February, especially her left eye. Her doctor sent her to get prescription glasses. The vision center had to adjust them and tilt them because the muscle in her eye won't let her eye move to see through the lens. It is her distance vision, mostly in her left eye. Her right eye droops and her left eye popped out. The shaking made her look like she had Tourette's. After she got medicine at the hospital it went away and her body calmed down. On Thursday it seemed okay. Her doctor said it was because she still had the IV medicine in her body. On Friday the medicine wore off and her heart was racing and it was making her body shake. Doctor said her heart was beating so quickly because her thyroid was causing her to make so much adrenaline and it caused her body to shake. 20 minutes after she took the propranolol it completely stopped.  On 07Apr2021 they suspected she had Grave's disease and Thyroid eye disease. The thyroid testing came back as unreadable. It came back as 0.01 UIU/mL. It was thyroid stimulating hormone. It was not a full panel, but that was enough to try to find out if it was her thyroid. The endocrinologist ordered full testing. The goiter was pressing on her throat and she had a hard time swallowing when she was eating. It was scratching her throat. She has gone to soft foods until it was easier to swallow. She can swallow on her own, but it was hard to swallow foods, it got stuck in her throat.  They told her she would get better with the thyroid medication. She lost weight so fast and would start to lose muscle. She was losing weight because her adrenaline was up. It had made her weak on 10Apr2021. They gave her a list of supplements and protein drinks. In October she started to exercise and lost a couple pounds between then and January. She was just taking long walks and thought it was going great. She had only lost a couple of pounds. After Wednesday her weight started rapidly changing, and every time she got weighed she had 3 more pounds gone. She started feeling really weak by the weekend. Her heart was making her feel weak, and she hadn't had any medicines yet and felt tired on 10Apr2021.  After Wednesday, she started having 2 bowel movements a day which is very strange. Her doctor said it is a symptom of hyperthyroid. Normally it is like clockwork in the morning and that's it. She noticed it on Thursday 08Apr2021. She became hypersensitive after Wednesday and paid attention to everything.  She already had seasonal allergies. She stopped any kind of decongestant. She knew with heart palpitations to stay away from that. She just took cetirizine hydrochloride (ZYRTEC) and fluticasone propionate (FLONASE). Her doctor said her body was used to that to keep her sinuses down, and with her body making so much adrenaline it could be excessive. Wearing a mask over her face was hard to breathe because the heart. She had trouble sleeping, which could be part of the fatigue because it was disturbing her sleep. They confirmed it was her thyroid on Monday and again Tuesday with more extensive labs for the correct level of methimazole.  Investigations included: She had a CBC with differential on 07Apr2021.  She had a CT orbit sella post fossa W contrast that showed facial swelling and periorbital edema of both eyes on 07Apr2021. The impression on the radiology digital imaging she can provide at a later time. She had mild symmetric ptosis on 07Apr2021 otherwise normal for appearance of orbital content. The impression for the CT scan on 07Apr2021 was bilateral perinasal sinus disease which was her allergies. The rest was stable coiling. She had vascular coiling directly behind her eye from the ruptured aneurysm.  The outcome of events Thyroid storm, vaccine caused some type of brain bleed, hyperthyroid, pain in her eye, Lost so much weight, Dry eye, blood pressure 171/86, Hypersensitivity, trouble sleeping, facial swelling, mild symmetric ptosis, trouble breathing was unknown, outcome of events Eye swelling, Tired, Weak was recovering, outcome of event shaking was recovered on 07Apr2021, outcome of other events was not recovered.