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This is VAERS ID 279329

Case Details

VAERS ID: 279329 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-01-03
Onset:2007-02-01
   Days after vaccination:29
Submitted: 2007-05-22
   Days after onset:109
Entered: 2007-05-23
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Epistaxis, Evans syndrome, Eye disorder, Idiopathic thrombocytopenic purpura, Menorrhagia, Transfusion
SMQs:, Haemolytic disorders (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Corneal disorders (broad), Retinal disorders (broad), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: None records received 6/6/07-nosebleeds
Allergies:
Diagnostic Lab Data: Unknown. records received 6/6/07-On admission platelets 4, smear showed no blasts, large in size. Reticulocyte mild hypogammaglobulinemia and positive direct Coombs. Trasnfusions of platelets. Bone marrow results were within normal limits with no blasts. Treated with IVIG. Blood cultures no growth. Positive ANA. CMV, Enterovirus, HSV/VZV cultures negative.
CDC Split Type: WAES0705USA02428

Write-up: Information has been received from a physician concerning a 15 year old female with no pertinent medical history or known drug reactions or allergies who on 03-JAN-2007 was vaccinated with Gardasil 0.5 ml injection. In February 2007, the patient experienced heavy menstrual bleeding, nose bleeds and eye problems and was hospitalized for four days (admittance and discharge dates not reported), and while hospitalized was diagnosed with Evans syndrome. The patient needed a blood transfusion. The patient''s Evans syndrome persisted. There was no product quality complaint. Additional information has been requested. 06/06/07-records received from facility for DOS 5/7-5/10/07. DC DX: Evan''s Syndrome, immune thrombocytopenia and anemia. Prolonged episode of epistaxis. HX: Nosebleeds frequently since age of 3 or 4. In last 4 weeks have increased in frequency 6-7 times per day, harder to stop. Prior to admission nosebleed from 21:30 through 9:30 with nausea and bloody emeses. HX of bruising easily. Menses 3 days longer in duration and heavier with clotting and clumps. Petechia on lower extremities, more tired or fatigued. Feels faints if she stands up too quickly. Black out this morning. Fell. Follow up visits 5/17/07: Impression Evan''s Syndrome, Strong family history of autoimmunity. Abnormal labs including positive ANA, low complement.


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