Age: 43.0
Sex: F
Vaccine: COVID19
Symptoms: Alanine aminotransferase, Albumin globulin ratio, Anti-thyroid antibody, Antinuclear antibody, Aspartate aminotransferase
Clinical narrative: Heartburn; Started noticing burning feeling on my chest; red/ itchy eyes; red/ itchy eyes; Chronic Spontaneous Urticaria / Chronic idiopathic urticaria; This spontaneous case was reported by a consumer and describes the occurrence of CHRONIC SPONTANEOUS URTICARIA (Chronic Spontaneous Urticaria / Chronic idiopathic urticaria), DYSPEPSIA (Heartburn), CHEST PAIN (Started noticing burning feeling on my chest), EYE PRURITUS (red/ itchy eyes) and OCULAR HYPERAEMIA (red/ itchy eyes) in a 43-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination.     The patient's past medical history included Smoker (Former Smoker (2 packs per week)), Tubal ligation on 01-Jan-2014, Myomectomy on 01-Jan-2011, Cholecystectomy on 01-Jan-2011 and Umbilical hernia repair (Umbilical Hernia) on 01-Jan-2010. Concurrent medical conditions included Environmental allergy (Puffy eyes runny nose sinus infection), Obesity since 09-Oct-2019, Premenstrual dysphoric disorder (Premenstrual Syndrome Management) since 09-Oct-2019, Atypical squamous cells of undetermined significance since 09-Oct-2019, Incontinence of urine since 04-Feb-2020, Menopause, Metabolic disorder and Seasonal allergy. Concomitant products included OLOPATADINE HYDROCHLORIDE (PATADAY) for Environmental allergy, FLUOXETINE from 05-Jan-2022 to an unknown date for Premenstrual dysphoric disorder, LORATADINE (CLARITIN [LORATADINE]) for Seasonal allergy, CYANOCOBALAMIN (B12 [CYANOCOBALAMIN]) for Unspecified disorder of metabolism, OXYBUTYNIN for Urinary urgency, INFLUENZA VACCINE (FLUZONE [INFLUENZA VACCINE]), TUBERCULIN PPD (TUBERSOL) from 17-Aug-2021 to an unknown date and FLUTICASONE PROPIONATE from 27-Apr-2020 to an unknown date for an unknown indication.   On 27-Feb-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 27-Mar-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 14-Jan-2022, received third dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On 29-Jan-2022 at 8:00 AM, the patient experienced CHRONIC SPONTANEOUS URTICARIA (Chronic Spontaneous Urticaria / Chronic idiopathic urticaria), EYE PRURITUS (red/ itchy eyes) and OCULAR HYPERAEMIA (red/ itchy eyes). On an unknown date, the patient experienced DYSPEPSIA (Heartburn) and CHEST PAIN (Started noticing burning feeling on my chest). The patient was treated with FAMOTIDINE (oral) from 08-Feb-2022 to 16-Feb-2022 at a dose of 20 mg,1 tablet twice a day by oral route.; METHYLPREDNISOLONE (MEDROL DOSEPAK) (oral) from 30-Jan-2022 to 05-Feb-2022 at a dose of 4 mg; PREDNISONE (oral) from 20-Feb-2022 to 03-Mar-2022 at a dose of Take 4 tablets for 3 days THEN take 3 tablets for 3 days THEN take 2 tablets for 3 days THEN take 1 tablets for 4 days; CETIRIZINE HYDROCHLORIDE (ZYRTEC [CETIRIZINE HYDROCHLORIDE]) at an unspecified dose and frequency; HYDROXYZINE HCL (oral) on 08-Feb-2022 for Itching, at a dose of 10mg,Take 1/4 to 1/2 tablet as needed for itching and OMALIZUMAB (XOLAIR) on 22-Mar-2022 at a dose of 1 dosage form. At the time of the report, CHRONIC SPONTANEOUS URTICARIA (Chronic Spontaneous Urticaria / Chronic idiopathic urticaria), DYSPEPSIA (Heartburn), CHEST PAIN (Started noticing burning feeling on my chest), EYE PRURITUS (red/ itchy eyes) and OCULAR HYPERAEMIA (red/ itchy eyes) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 08-Feb-2022, Alanine aminotransferase (17-32): 17 17 IU/L. On 08-Feb-2022, Albumin globulin ratio (1.2-2.2): 2.2 2.2. On 08-Feb-2022, Aspartate aminotransferase (0-40): 19 19 IU/L. On 08-Feb-2022, Blood albumin (3.8-4.8): 4.6 4.6 g/dL. On 08-Feb-2022, Blood alkaline phosphatase (44-121): 53 53 IU/L. On 08-Feb-2022, Blood bilirubin (0.0-1.2): 0.2 0.2 mg/dL. On 08-Feb-2022, Blood calcium (8.7-10.2): 9.3 9.3  mg/dL. On 08-Feb-2022, Blood chloride (96-106): 101 101  mmol/L. On 08-Feb-2022, Blood creatinine (0.57-1.00): 0.55 (Low) 0.55 mg/dL. On 08-Feb-2022, Blood glucose (65-99): 88 88 mg/dL. On 08-Feb-2022, Blood potassium (3.5-5.2): 4.2 4.2 mmol/L. On 08-Feb-2022, Blood pressure measurement: 104/68 104/68 mm[Hg]. On 08-Feb-2022, Blood sodium (134-144): 140 140 mmol/L. On 08-Feb-2022, Blood urea (6-24): 12 12 mg/dL. On 08-Feb-2022, Blood urea nitrogen/creatinine ratio (9-23): 22 22. On 08-Feb-2022, Body temperature: 98.2 98.2 F°. On 08-Feb-2022, Carbon dioxide (20-29): 21 21 mmol/L. On 08-Feb-2022, Globulin (1.5-4.5): 2.1 2.1  g/dL. On 08-Feb-2022, Heart rate: 70 (normal) 70 bpm regular. On 08-Feb-2022, Oxygen saturation: 97 97% Room Air at Rest. On 08-Feb-2022, Protein total normal (6.0-8.5): 6.7 6.7g/dL. On 08-Feb-2022, Respiratory rate increased: 20 20. On 09-Feb-2022, Blood thyroid stimulating hormone (0.530-6.340): 1.170 1.170 uIU/mL. On 16-Feb-2022, Antinuclear antibody: negative (Negative) NEGATIVE. On 16-Feb-2022, Blood cholesterol (100-199): 192 192 mg/dL. On 16-Feb-2022, Blood pressure measurement: 114/73 114/73 mm[Hg]. On 16-Feb-2022, Blood triglycerides (0-149): 72 72 mg/dL. On 16-Feb-2022, Body temperature: 97.5 97.5 F°. On 16-Feb-2022, Heart rate: 60 60 bpm regular. On 16-Feb-2022, High density lipoprotein (>39-Unknown): 51 51 mg/dL. On 16-Feb-2022, LDL/HDL ratio (0.0-3.2): 2.5 2.5. On 16-Feb-2022, Low density lipoprotein (0-99): 128 (High) 128 mg/dL. On 16-Feb-2022, Oxygen saturation: 97 97% Room Air at Rest. On 16-Feb-2022, Respiratory rate increased: 20 20. On 16-Feb-2022, Very low density lipoprotein (5-40): 13 13 mg/dL. On 17-Feb-2022, Blood follicle stimulating hormone: 44.9 44.9 mIU/mL. On 17-Feb-2022, Blood luteinising hormone: 67.4 67.4 mIU/mL. On 17-Feb-2022, C-reactive protein (0-1): <1 <1 mg/L. On 17-Feb-2022, Helicobacter test positive (0.00-0.79): 0.23 0.23. On 17-Feb-2022, Oestradiol: 126 126.0 pg/mL. On 17-Feb-2022, Rheumatoid factor (Unknown-<14.0): <10.0 <10.0 IU/mL. On 25-Feb-2022, Blood cholesterol (100-199): 247 (High) 247 mg/dL. On 25-Feb-2022, Blood triglycerides (0-149): 89 (normal) 89 mg/dL. On 25-Feb-2022, High density lipoprotein (>39-Unknown): 56 (normal) 56 mg/dL. On 25-Feb-2022, LDL/HDL ratio (0.0-3.2): 3.1 (normal) 3.1. On 25-Feb-2022, Low density lipoprotein (0-99): 176 (High) 176 mg/dL. On 25-Feb-2022, Very low density lipoprotein (5-40): 15 (normal) 15 mg/dL. On 27-Mar-2022, Blood thyroid stimulating hormone (0.530-6.340): 0.576 0.576 u[IU]/mL. On 27-Mar-2022, Thyroxine (0.60-1.60): 0.74 0.74 ng/dL. On 29-Mar-2022, Anti-thyroid antibody (0-34): <8 <8.         15 days after Moderna booster patient noticed body was itchy in random places all throughout the day, hands legs and breasts especially with red wheals in the areas where patient were itchy. Patient went to the ER the next day as the urticaria had worsened and wanted to ensure patient wasn't contagious. ER told that it was an allergic reaction to hair dye or laundry soap. Patient started noticing burning feeling on chest with no wheals and a cooling sensation while inhaling (possible anaphylaxis) so called Dr again and got another appointment. Seen PCP again 2/16/2022 more labs drawn; CRP, ANA, RF, IgM abs, Estradiol FSH & LH only to return with elevated estrogen levels consistent with transitioning to menopause. Given a higher dose longer round of steroids (started to see relief until the dose tapered down), referred to allergist and taken off famotidine. Return to PCP for the annual Lipid panel run and fingerstick done, LDL was high and recommended dietary and exercises. Saw allergist on 3/10/2022, did skin testing and stated allergic to foods. Patient did get another round of steroids which patient had seen results from. Patient was diagnosed with Chronic Spontaneous Urticaria and was eligible for Xolair, a monthly shot for people with Chronic Urticaria with no medical reason. Return to see PCP on 3/17/2022 with findings from the allergist and PCP refers to Endocrine to test for possible thyroid issues with no marker. Go back to the allergist 3/22/2022 for the first Xolair shot. Visited Endocrine on 3/25/2022 and sonogram for thyroid. Still waiting results of test and sonogram. So far Xolair has kept patient pretty comfortable, and the skin was sort of returning to normal. Patient had heart burn with indigestion.