Age: 74.0
Sex: M
Vaccine: COVID19
Symptoms: Magnetic resonance imaging, Muscular weakness, Positron emission tomogram, Prostatic specific antigen, Urine albumin/creatinine ratio
Clinical narrative: Claudication; Neck muscle weakness; Mixed cellularity hodgkin lymphoma of lymph node of multiple regions; This spontaneous case was reported by a nurse and describes the occurrence of HODGKIN'S DISEASE MIXED CELLULARITY STAGE UNSPECIFIED (Mixed cellularity hodgkin lymphoma of lymph node of multiple regions) in a 74-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 044B21A and 046A21A) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.     The patient's past medical history included Gastroenteritis (Due to novovirus) from 14-Mar-2022 to 20-Mar-2022, Aneurysm of unspecified site from 14-Apr-2021 to 11-Jan-2022, Ventricular tachycardia from 14-Apr-2021 to 08-Oct-2021, Non ST segment elevation myocardial infarction (ICD-10-CM I21.4, priority low) from 10-Jul-2018 to 08-Oct-2021, Community acquired pneumonia (ICD-10-CM J18.9 and priority low) from 15-Nov-2016 to 14-Jun-2018, Hemoptysis (Had few episodes of Scant hemoptysis.) in November 2016, Dry cough (Residual) in 2016, Bronchoscopy (Bronchoscopy with transbronchial bx) on 21-Dec-2021, CABG (CABG×1, LIMA-LAD) on 08-Oct-2015 and Cardiac catheterization (Showed severe disease in LAD, first diagonal and septal branch.) on 07-Oct-2015. Previously administered products included for Community acquired pneumonia: Cherritussin (6 days) from 06-Nov-2016 to November 2016 and Levaquin (6 days) from 06-Nov-2016 to November 2016. Past adverse reactions to the above products included No adverse event with Cherritussin and Levaquin. Concurrent medical conditions included Drug allergy (Baclofen), Allergy to antibiotic (Clindamycin), Allergy to antibiotic (Doxycycline), Grass allergy, Drug allergy (Mexloxicam), Drug allergy (Propranolol), Drug allergy (Sulfa allergy), Allergy to antibiotic (Vibramycin), Pulmonary hypertension NOS (Unspecified, Chronic, 127.20,Low) since 14-Apr-2021, Adenomatous polyposis coli (ICD-10-CM Z86.010 and priority low) since 27-Aug-2021, Unstable angina (ICD-10-CM 120.0 and priority low) since 10-Jul-2018, Combative reaction (ICD-10-CM  Z78.9, priority low) since 14-Jun-2018, Postoperative delirium (Postoperative delirium after anesthesia lasting minutes to hours) since 14-Jun-2018, Laceration of leg (Left,ICD-10-CM was S81.812A and priority was low) since 03-Oct-2017, Parotid tumour (ICD-10-CM D49.0, priority low) since 16-May-2017, Hyperlipidemia (Mixed, Chronic. ICD-10-CM  E78.2, priority low) since 20-Nov-2016, Posterior vitreous detachment (Both eye. ICD-10-CM H43.813, priority low) since 06-Sep-2016, Nuclear sclerosis of the eye (Both eye. ICD-10-CM H25.13 and priority low) since 06-Sep-2016, Knee pain (Bilateral chronic M25.561, M25.562, G89.29, Low) since 02-Jun-2016, Cyst (Cyst of neck. ICD-10-CM IMO0002 and priority low) since 01-Mar-2016, Benign prostatic hyperplasia (Non-nodular.ICD-10-CM N40, priority low) since 01-Dec-2015, Lower urinary tract symptoms (Chronic) on 01-Dec-2012, Type 2 diabetes mellitus (Controlled. ICD-10-CM E11.59, priority low), Type II diabetes mellitus with peripheral circulatory disorders (ICD-10-CM  E11.59 and priority low), Hematuria (ICD-10-CM was R31 priority low) since 15-Oct-2015, Essential hypertension (Chronic. ICD-10-CM was I10 and priority was low) since 15-Oct-2015, Coronary artery disease (involving native coronary artery of native heart) since 07-Oct-2015, Angina pectoris (Chronic) since 07-Oct-2015 and Diverticulitis of colon (without mention of hemorrhage) (ICD-10-CM K57.32, priority low.) since 16-Sep-2015. Concomitant products included TAMSULOSIN HYDROCHLORIDE (FLOMAX [TAMSULOSIN HYDROCHLORIDE]) for Benign prostatic hyperplasia, Lower urinary tract symptoms and Essential hypertension, ASPIRIN [ACETYLSALICYLIC ACID] for Coronary artery disease, METOPROLOL for Essential hypertension, ATORVASTATIN for Hyperlipidaemia, METFORMIN for Type 2 diabetes mellitus, LISINOPRIL for Type 2 diabetes mellitus and Essential hypertension, CLOPIDOGREL BISULFATE (PLAVIX) for an unknown indication.   On 18-Mar-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) .5 milliliter. On 16-Apr-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) dosage was changed to .5 milliliter. On 11-Jan-2022, the patient experienced HODGKIN'S DISEASE MIXED CELLULARITY STAGE UNSPECIFIED (Mixed cellularity hodgkin lymphoma of lymph node of multiple regions) (seriousness criterion medically significant). On 12-Jan-2022, the patient experienced INTERMITTENT CLAUDICATION (Claudication) and MUSCULAR WEAKNESS (Neck muscle weakness). At the time of the report, HODGKIN'S DISEASE MIXED CELLULARITY STAGE UNSPECIFIED (Mixed cellularity hodgkin lymphoma of lymph node of multiple regions), INTERMITTENT CLAUDICATION (Claudication) and MUSCULAR WEAKNESS (Neck muscle weakness) had not resolved. Not Provided    DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On 29-Jun-2015, Urine albumin/creatinine ratio: 7.4 7.4 mcg/mg Creat. On 25-May-2016, Prostatic specific antigen: 0.54 (Low) 0.54 ng/ml. On 18-Nov-2016, Glycosylated haemoglobin: 6.1 (High) 6.1 percent. On 18-Nov-2016, Urine albumin/creatinine ratio: 6.3 6.3 mcg/ml. On 01-May-2017, Glycosylated haemoglobin: 6.2 (High) 6.2 percent. On 01-May-2017, Prostatic specific antigen: 0.39 (Low) 0.39 ng/ml. On 07-Dec-2017, Blood cholesterol: 93 93, at 7.49 am. On 07-Dec-2017, Blood triglycerides: 167 (High) 167, at 07.49 am. On 07-Dec-2017, Glycosylated haemoglobin: 6.0 (High) 6.0 percent. On 07-Dec-2017, High density lipoprotein: 32 (Low) 32, at 7.49 am. On 07-Dec-2017, Low density lipoprotein: 28 (normal) At 07.49 am CALCLDL 28. On 07-Dec-2017, Urine albumin/creatinine ratio: 6.1 6.1 mcg/ml. On 18-Dec-2017, Magnetic resonance imaging: left medial meniscus tear (abnormal) left medial meniscus tear, was scheduled for arthroscopy on 25-NOV-2016.. On 11-Jun-2018, Glycosylated haemoglobin: 6.0 (High) 6.0 percent. On 10-Jul-2018, Blood cholesterol: 111 111, at 1.50 am. On 10-Jul-2018, Blood triglycerides: 164 (High) 164. On 10-Jul-2018, High density lipoprotein: 35 (Low) 35, at 1.50 am. On 10-Jul-2018, Low density lipoprotein: 43 (normal) At 1.50 am CALCLDL 43. On 11-Jul-2018, Blood creatinine: 0.97 0.97 mg/dL. On 12-Jul-2018, Blood creatinine: 0.95 0.95 mg/dL. On 20-Oct-2021, Ejection fraction: 60 60 percent. On 16-Feb-2022, Biopsy: results not reported Results not reported, Left neck biopsy. On an unknown date, Positron emission tomogram: results pending Results pending.     For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter did not provide any causality assessments.   The patient had controlled Type 2 diabetes with circulatory disorder without long term current use of insulin (Chronic). On Sep 2015 he underwent sigmoid colon resection. On 07 Oct 2015, ICD-10-CM of CAD with angina pectoris was I25.119 and priority was low. On 08 Oct 2015, his s/p previous single LIMA to LAD CABG. His circumflex and RCA were free of significant disease. On 01 Dec 2015, ICD-10-CM of benign non-nodular prostatic hyperplasia with lower urinary tract symptoms was N40.1 and priority was low. On 2016 patient had a growing irritating neck cyst which he wanted to remove. 0n 02 Jun 2016, ICD-10-CM of bilateral chronic knee pain was M25.561, M25.562, G89.29 and priority was low. On 06 Nov 2016, patient visited ED for 2 day history of low grade fever, malaise, cough productive of tan sputum and was diagnosed with CAP. Had no fever, chills and appetite returned. On May 2017, patient had resected left parotid tumor and pathology revealed pleomorphic adenoma (benign mixed tumor) and on Oct 2017, patient had small laceration on left leg from running up against some aluminum. He kept it clean and dressed, however should had received a suture as it was slightly open and healed by secondary intension. On 15 May 2018, adult BMI was 40.0-44.9 kg/sq m. Patient had no current chest pain or dyspnea symptoms despite being active. ICD-10-CM of pulmonary hypertension was I27.20, aneurysm was I72.9 and ventricular tachycardia was I47.2, and priority were low for all.  Concomitant medication include ACE inhibitor. He was well controlled on oral medications. He discontinued Plavix now.  The ICD-10-CM of event Claudication was 173.9, Neck muscle weakness was M53.82 and mixed cellularity Hodgkin lymphoma of lymph nodes of multiple regions was C81.28 and priority for all events was reported as Low. No treatment information was provided.  On 04-JAN-2022, The patient had tested negative for malignancy.  This case was linked to MOD-2022-526143, MOD-2022-503788 (Patient Link).  Company comment: This case concerns a 74-year-old male patient with a medical history of Type 2 diabetes with circulatory disorder, hypertension and Hyperlipidemia, who experienced the unexpected serious event of Hodgkin's disease mixed cellularity stage unspecified and non-serious events of Intermittent claudication and Muscular weakness approximately 9 months after receiving the second dose of mRNA-1273 vaccine. Patients medical history of Type 2 diabetes with circulatory disorder, hypertension and Hyperlipidemia could be risk factors to Intermittent claudication and patients elderly age could be confounding for Muscular weakness. The benefit-risk relationship of mRNA-1273 vaccine is not affected by this report.  Sender's Comments: This case concerns a 74-year-old male patient with a medical history of Type 2 diabetes with circulatory disorder, hypertension and Hyperlipidemia, who experienced the unexpected serious event of Hodgkin's disease mixed cellularity stage unspecified and non-serious events of Intermittent claudication and Muscular weakness approximately 9 months after receiving the second dose of mRNA-1273 vaccine. Patients medical history of Type 2 diabetes with circulatory disorder, hypertension and Hyperlipidemia could be risk factors to Intermittent claudication and patients elderly age could be confounding for Muscular weakness. The benefit-risk relationship of mRNA-1273 vaccine is not affected by this report.