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This is VAERS ID 276629

Case Details

VAERS ID: 276629 (history)  
Form: Version 1.0  
Age: 12.0  
Sex: Female  
Location: Maine  
   Days after vaccination:26
Submitted: 2007-04-17
   Days after onset:63
Entered: 2007-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: Private
Symptoms: Anaemia haemolytic autoimmune
SMQs:, Haemolytic disorders (narrow), Systemic lupus erythematosus (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Migraine Records received 4/24/07-PMH: meconium aspiration ventilated for 10 days, full term. Several episodes of dehydration as a toddler required ER visits and IV hydration.
Diagnostic Lab Data: Available Records received 4/24/07-hemoglobin 5.4 and hematocrit 17. WBC 3.6. Platelets 211,000. LDH 493. Total Bilirubin 3.8. DAT Coombs found to have IgG anti-e antibody. Retic count elevated.
CDC Split Type:

Write-up: Acute onset Autoimmune hemolytic anemia requiring IV steroids and hospitalization.Records received 4/24/07-from facility for DOS 02/13-02/15/07- DC DX: warm agglutinin autoimmune hemolytic anemia. Found at routine visit to be anemic by PCP. RX with high dose steroids. Two week HX of fatigue pallor, nauseated. 4-6 weeks prior had URI .

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