hypoaldosteronism, excessive fatigue; hirsutism, an increase of hair growing on pt's face and chest.; chronic migraines; menstrual irregularities; POTS, nausea, dizziness, fatigue, chest pain, trouble breathing, presyncope, tachycardia, heart palpitations, difficulty concentrating, unrefreshing sleep, vertigo, lowblood pressure, blurred vision visual disturbances; orthostatic intolerance (OI); she began to experience symptoms of autonomic dysfunction such as trembling, chaking, chest pressure, palpitations and headaches; stomach cramps, nausea, decreased appetite, cold and clammy extremities, heat intolerance; Information has been received regarding a case in litigation from a lawyer and referred to a currently adult female patient (pt.) of unknown age. Information on the pt's concurrent conditions, medical history or concomitant therapy was not reported. It was reported that she was happy and physically very active without autonomic issues, no tachycardia, and no orthostasis; she had met all expected developmental milestones to that point; she was a good student and was doing very well in her classes; and was very physically active and enjoyed spending time with her friends. On 05-NOV-2012 during a physical examination, the pt's pediatrician recommended that pt receive quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) vaccine an on the same date (at the age of 14), and under the consent of pt's mother, the pt. was vaccinated with a first dose of quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) for prevention of cervical cancer (lot#, expiration date, dose, route of administration and anatomical location were not reported). Soon after the pt. was vaccinated with the first dose, she developed symptoms of fatigue, dizziness, and nausea. Pt. and her parents noticed an increase of hair growing on pt's face and chest. On 04-FEB-2013 (at the age of 15), the pt. returned to the pediatrician's office to receive the second dose of quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) for prevention of cervical cancer (lot#, expiration date, dose, route of administration and anatomical location were not reported). It was after this second shot of quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) that pt. began to experience symptoms of dysautonomia, such as trembling, shaking, chest pressure, palpitations, and headaches. On 18-MAR-2013 and on 28-MARCH-2013, the pt. was taken to the hospital for episodes of chest pains, dizziness, and tachycardia (unclear if she was admitted to the hospital due to the events). As the months progressed, so did pt's injuries. She was seen by multiple physicians and specialists for her complaints which now included: dizziness; chest pains; trouble breathing; presyncope; tachycardia and heart palpitations; nausea and stomach cramps; decreased appetite; excessive fatigue; difficulty concentrating; unrefreshing sleep; vertigo; low blood pressure; blurry vision and visual disturbances; cold and clammy extremities; heat intolerance; chronic migraines; and menstrual irregularities. Therefore, it was claimed, that the pt. sustained autoimmune disease and other serious injuries, including but not limited to postural orthostatic tachycardia syndrome ("POTS"), orthostatic intolerance ("OI"), and autonomic dysfunction as a result of his quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) injections. It was claimed that quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) and its ingredients caused pt's autoimmune disease and other related injuries and resulted in her suffering from severe, debilitating, disabling and painful chronic injuries. As a result of her post-quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) symptoms, pt. was unable to engage in normal activities that a normal teenager would enjoy. She had trouble keeping up with classes during her sophomore year of high school and did the majority of this grade at home. Pt. was unable to attend college classes on campus due to her extreme fatigue. Based upon her chronic and severe post-quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL) symptoms and adverse events as outlined above and the tests performed by dozens of medical providers, pt had been diagnosed with various medical conditions, including but not limited to POTS, OI, autonomic dysfunction, hypoaldosteronism, hirsutism, and chronic migraines. As a proximate result of vaccination, pt. had suffered and continued to suffer severe and permanent physical injuries and associated symptomology and had suffered severe and permanent emotional injuries, including pain and suffering. Pt. also had a substantial fear of suffering additional and ongoing harms, including but not limited to now being at an increased risk of cancer and future symptoms and harms associated with her autoimmune disease as a result of her exposure to quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL). At the reporting time, she was not recover from the events. The reporter considered all events to be disabling and related to quadrivalent human papillomavirus (types 6,11,16,18) recomb. vaccine (GARDASIL).