Age: 57.0
Sex: M
Vaccine: HEP
Symptoms: Plasmapheresis, Polyneuropathy, Prothrombin time prolonged, Ultrasound Doppler, Ultrasound Doppler abnormal
Clinical narrative: On night of 9/27/2000 while employed as correctional officer, I was administered the second of only two vaccinations I received for hepatitis-B at the medical clinic. Within approximately two hours I began to feel light headed, nauseated and felt "achy" all over.  The symptoms lasted throught the night and the next morning, and in the afternoon I went to my corrections academy class feeling slightly ill but began to feel better. The class included a mile run every day in formation, and typically I would extend my run individually after the other class members had finished, since I had always been accustomed to running three miles each day prior to my employment as a C/O.  Within a week after having the vaccination, as the class would watch me finish my run, they began to tell me I was dragging my feet, and I should pick up my feet. During the next week (October) I began having numbness in my left foot. On 11/18/2000, while doing nothing but standing beside my car, I experienced the wavelike onset of an excruciating lumbar pain which kept me flat on my back for the weekend. On 11/23, Numbness and tingling became pronounced bilaterally in my toes. During the next week I attempted to continue attending my academy classes but became increasingly unable to lift my feet, step up curbs and go up stairs. My gait became uncontrollable. The numbness and weakness also started in my hands, and on 12/6/2000 I could no longer stand or walk without help. I was first diagnosed by a neurologist on 12/6 with Guillain Barre Syndrome and was hospitalized and treated with therapeutic plasma pheresis exchanges. I was discharged on 12/14/2000 with a walker to have physical therapy and more TPE. I continued to grow weaker and have relapses and additional lengthy hospital admissions. In March 2001, because of the chronic, relapsing symptoms, my diagnosis was changed to chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). This was confirmed by lumbar puncture and nerve conduction studies. My functional level is the equivalent of a C-5 quadriplegic. I have had numerous complications from the condition and the meds used to suppress my auto-immune system to prevent relapses. 12/27/06-records received and reviewed for DOS 12/6-12/14/2000. DC DX: Guillain Barre Syndrome HX of present illness: Over past several months doing significant physical type work, falling and he had multiple trauma to his hips and back, significant pain in lower back and thoracic spine. Past several months had severe anxiety, depression and weight loss.  Hospital Course: Treatment included plasmapheresis. Developed prolonged PT and PTT, PT 10.7 PTT 30.0 EMG: polyneuropathy principally affecting the motor nerves to a greater extent than the sensory nerves. Clinically this is an acute picture which is consistent with a Guillain-Barre syndrome. Same as previously reported.  Paralysis, absence of propriocyption, lymphedema, orthostatic hypotension, cushings syndroms & other symptoms of C.I.D.P.  Muscle atrophy continues due to lack of nerve conduction to lower extremities bilaterally. Follow up information:Patient has not recovered. Same as previously reported. Paralysis, absence of proprioception, lymphedema, orthostatical hypertension, CUSHING'S syndrome & other symptoms of C.I.D.P. Muscle atrophy continues due to lack of nerve conduction to lower extremities bilaterally.