Sex: M
Vaccine: COVID19
Symptoms: Blood glucose, Blood pressure measurement, Blood thyroid stimulating hormone, CSF culture, Computerised tomogram head
Clinical narrative: Adrenal crisis; This is a literature report for the following literature source(s): "Adrenal crisis secondary to Covid-19 vaccination in patient with hypopituitarism", Clinical Case Reports, 2022; DOI:10.1016/j.aace.2022.04.004.This is a follow-up report based on the receipt of the publication; the case has been updated to include additional information identified in the publication.  A 74-year-old male patient received BNT162b2 (BNT162B2), as dose 2, single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history included: "prolactinoma" (unspecified if ongoing), notes: in 1980s; "surgical resection", start date: 1980 (unspecified if ongoing), notes: in 1980s; "hypopituitarism" (unspecified if ongoing), notes: on hormone replacement therapy; "diabetes mellites type 2" (unspecified if ongoing); "essential hypertension" (unspecified if ongoing). The patient's concomitant medications were not reported. Vaccination history included: BNT162b2 (DOSE 1, SINGLE), administration date: 09Mar2021. The following information was reported: ADRENOCORTICAL INSUFFICIENCY ACUTE (medically significant, life threatening), outcome "unknown", described as "Adrenal crisis". The event "adrenal crisis" required emergency room visit. The patient underwent the following laboratory tests and procedures: Angiogram: negative, notes: for any acute central nervous system (CNS) pathology; Bacterial test: negative; Blood alcohol: undetectable; Blood cortisol: 1.91 ug/dL; Blood glucose: 20 mg/dl; 143 mg/dl; Blood pressure measurement: 145/84 mmHg; 107/71 mmHg, notes: subsequently decreased; Blood thyroid stimulating hormone: 0.006 uiU/mL; Computerised tomogram head: negative, notes: for any acute central nervous system (CNS) pathology; CSF culture: within normal limits; Full blood count: normal; Heart rate: 105, notes: Units: beats/minute; Metabolic function test: normal; Physical exam: responsive only to painful stimuli with no focal, notes: deficit; Pyrexia: 103.5 Fahrenheit; Thyroxine: 1.90 ng/dL; Toxicologic test: negative; Viral test: negative. Therapeutic measures were taken as a result of adrenocortical insufficiency acute.  No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.  Follow-up (09May2022): The initial case was missing the following minimum criteria: Unspecified product. Upon receipt of follow-up information on (09May2022), this case now contains all required information to be considered valid.; Sender's Comments: Based on the information available and temporal association, a possible contributory role of the suspect BNT162B2 cannot be excluded for the reported events . The case will be reassessed once new information is available   The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.,Linked Report(s) : US-PFIZER INC-202200690015 Same article/ drug/event and different patient: