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This is VAERS ID 350284

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 350284
Age:13.0
Gender:Female
Location:California
Vaccinated:2008-12-29
Onset:2008-12-31
Submitted:2009-06-26
Entered:2009-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0229X / 2 UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Alanine aminotransferase increased, Aphasia, Arthralgia, Arthritis, Aspartate aminotransferase increased, Biopsy kidney abnormal, Blood creatinine increased, Blood urea increased, Cardiolipin antibody positive, Chorea, Clumsiness, Confusional state, Electroencephalogram normal, Encephalitis, Glomerulonephritis, Haematuria, Haemoglobin decreased, Headache, Immunisation reaction, Joint effusion, Joint swelling, Lumbar puncture normal, Memory impairment, Mouth ulceration, Musculoskeletal pain, Nephritis, Nuclear magnetic resonance imaging brain normal, Petechiae, Platelet count decreased, Proteinuria, Purpura, Pyrexia, Rash, Red blood cells urine positive, Screaming, Skin exfoliation, Synovitis, Systemic lupus erythematosus, Ultrasound kidney normal, Urine analysis, White blood cell count increased, White blood cells urine positive, X-ray, Red blood cell sedimentation rate increased, Abasia, Specific gravity urine increased, Complement factor C3 decreased, Complement factor C4 decreased, Tongue eruption, Protein urine present, Urine protein/creatinine ratio abnormal, Histone antibody positive, Haemoglobin urine, Russell's viper venom time abnormal, Glucose-6-phosphate dehydrogenase, Antinuclear antibody positive, DNA antibody positive, Adverse drug reaction, Angiogram normal, Autoimmune disorder, Coagulation test abnormal, Immediate post-injection reaction, Butterfly rash

Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: Periodic swelling of lip and eye~HPV (Gardasil)~1~9~Sibling
Other Medications: None
Current Illness: None
Preexisting Conditions: None. PMH: none. Sib with oligoarticular juvenile ideopathic arthritis and aunt with RA. Allergy to sulfa and augmentin. 7/31/09 Hospital discharge summary received DOS 7/7/09 to 7/12/09. Bactrim allergy.
Diagnostic Lab Data: Blood work of DNA, ANA, complement levels. Urine analysis. X-rays of ankles. Later did Histone tests which indicated strong positive for Drug Induced Lupus. Labs and Diagnostics: Hgb low. Platelets low. BUN 25. AST/ALT in the 80''s. C3/C
CDC 'Split Type':

Write-up:Immediately following vaccine, patient began to complain of mild symptoms (my shoulder hurts, my wrist hurts, look at these spots on my leg. On the 5th of January, she came home from school with pain in both of her ankles but after resting and and Advil, she felt ok to go school. She came home from school on the 6th screaming in pain. Her ankles were so swollen, we had a lot of trouble getting her boots off. She couldn''t walk and had a rash all over her legs and ankles. We saw a pediatrician who immediately sent us to hospital. She had lots of tests and IV steroids and antibiotics. They later diagnosed her with Lupus. PCP records received as well as note from admission DOS 7/7-12/2009. Pt initially presented Jan 8, 2008 with c/o 5 day hx of bilateral ankle pain and rash of the ankle, calf and thigh. Seen in ER with PE (+) for petechial purpuric rash and low grade fever. Tx with abx and steroids and d/c for outpt f/u. Rheum consult PE (+) for L ankle effusion and decreased ROM. R ankle (+) for synovial thickening. Scant petechial lesions on LEs. ? Gardasil trigger for autoimmune disease with arthritis. F/U 1/15/09 with dx: Lupus. F/U 2/19/09, 4/6/09 with Impression: The presence of anti-histone AB suggests drug-induced Lupus 2'' to Gardasil. F/U 6/22/09 with c/o H/A, joint pain, mouth sores and rash. Assess: Worsening Lupus now with nephritis. Admitted 7/7-12/09 with D/C DX: Lupus cerebritis, lupus glomerulonephritis for c/o difficulty with word finding and increasing clumsiness. Nephrology consult for hematuria and proteinuria. 7/31/09 Hospital discharge summary received DOS 7/7/09 to 7/12/09. Assessment: Lupus cerebritis, lupus glomerulonephritis. Patient presented with 6 days of increasing difficulty finding words and general confusion. Choreiform movements and difficulty with memory. Palmar peeling after Cytoxan treatment. Papules on tongue. Malar rash. ICD-9: Diagnosis 710.0 Systemic lupus erythematosus Other causes of encephalitis and encephalomyelitis: 323.814,


Changed on 4/14/2017

VAERS ID: 350284 Before After
Age:13.0
Gender:Female
Location:California
Vaccinated:2008-12-29
Onset:2008-12-31
Submitted:2009-06-26
Entered:2009-06-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0229X / 2 UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Alanine aminotransferase increased, Aphasia, Arthralgia, Arthritis, Aspartate aminotransferase increased, Biopsy kidney abnormal, Blood creatinine increased, Blood urea increased, Cardiolipin antibody positive, Chorea, Clumsiness, Confusional state, Electroencephalogram normal, Encephalitis, Glomerulonephritis, Haematuria, Haemoglobin decreased, Headache, Immunisation reaction, Joint effusion, Joint swelling, Lumbar puncture normal, Memory impairment, Mouth ulceration, Musculoskeletal pain, Nephritis, Nuclear magnetic resonance imaging brain normal, Petechiae, Platelet count decreased, Proteinuria, Purpura, Pyrexia, Rash, Red blood cells urine positive, Screaming, Skin exfoliation, Synovitis, Systemic lupus erythematosus, Ultrasound kidney normal, Urine analysis, White blood cell count increased, White blood cells urine positive, X-ray, Red blood cell sedimentation rate increased, Abasia, Specific gravity urine increased, Complement factor C3 decreased, Complement factor C4 decreased, Tongue eruption, Protein urine present, Urine protein/creatinine ratio abnormal, Histone antibody positive, Haemoglobin urine, Russell's viper venom time abnormal, Glucose-6-phosphate dehydrogenase, Antinuclear antibody positive, DNA antibody positive, Adverse drug reaction, Angiogram normal, Autoimmune disorder, Coagulation test abnormal, Immediate post-injection reaction, Butterfly rash

Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations: Periodic swelling of lip and eye~HPV (Gardasil)~1~9~Sibling (Gardasil)~1~8.70~Sibling
Other Medications: None
Current Illness: None
Preexisting Conditions: None. PMH: none. Sib with oligoarticular juvenile ideopathic arthritis and aunt with RA. Allergy to sulfa and augmentin. 7/31/09 Hospital discharge summary received DOS 7/7/09 to 7/12/09. Bactrim allergy.
Diagnostic Lab Data: Blood work of DNA, ANA, complement levels. Urine analysis. X-rays of ankles. Later did Histone tests which indicated strong positive for Drug Induced Lupus. Labs and Diagnostics: Hgb low. Platelets low. BUN 25. AST/ALT in the 80''s. C3/C C3/C4 low. ANA (+), anti-DNA Ab (+). Anticardiolipin elevated. Anti-histone Ab (+). MRI/MRA brain WNL. EEG WNL. Creatinine 20. WBC 12.7. Renal US WNL. 7/31/09 Hospital discharge summary received DOS 7/7/09 to 7/12/09. LABS and DIAGNOSTICS: NEPHROLOGY. Urinalysis - elevated specific gravity, 3+ protein, 3+ hemoglobin, red cells and white cells, protein/creatinine ratio 3.8. Renal biopsy membranoproliferative glomerulonephritis. NEUROLOGY. EEG, MRI, MRA - unremarkable. INFECTIOUS DISEASE. G6PD - Pending. HEMA
CDC 'Split Type':

Write-up:Immediately following vaccine, patient began to complain of mild symptoms (my shoulder hurts, my wrist hurts, look at these spots on my leg. On the 5th of January, she came home from school with pain in both of her ankles but after resting and and Advil, she felt ok to go school. She came home from school on the 6th screaming in pain. Her ankles were so swollen, we had a lot of trouble getting her boots off. She couldn''t walk and had a rash all over her legs and ankles. We saw a pediatrician who immediately sent us to hospital. She had lots of tests and IV steroids and antibiotics. They later diagnosed her with Lupus. PCP records received as well as note from admission DOS 7/7-12/2009. Pt initially presented Jan 8, 2008 with c/o 5 day hx of bilateral ankle pain and rash of the ankle, calf and thigh. Seen in ER with PE (+) for petechial purpuric rash and low grade fever. Tx with abx and steroids and d/c for outpt f/u. Rheum consult PE (+) for L ankle effusion and decreased ROM. R ankle (+) for synovial thickening. Scant petechial lesions on LEs. ? Gardasil trigger for autoimmune disease with arthritis. F/U 1/15/09 with dx: Lupus. F/U 2/19/09, 4/6/09 with Impression: The presence of anti-histone AB suggests drug-induced Lupus 2'' to Gardasil. F/U 6/22/09 with c/o H/A, joint pain, mouth sores and rash. Assess: Worsening Lupus now with nephritis. Admitted 7/7-12/09 with D/C DX: Lupus cerebritis, lupus glomerulonephritis for c/o difficulty with word finding and increasing clumsiness. Nephrology consult for hematuria and proteinuria. 7/31/09 Hospital discharge summary received DOS 7/7/09 to 7/12/09. Assessment: Lupus cerebritis, lupus glomerulonephritis. Patient presented with 6 days of increasing difficulty finding words and general confusion. Choreiform movements and difficulty with memory. Palmar peeling after Cytoxan treatment. Papules on tongue. Malar rash. ICD-9: Diagnosis 710.0 Systemic lupus erythematosus Other causes of encephalitis and encephalomyelitis: 323.814,


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