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This is VAERS ID 486419

Case Details

VAERS ID: 486419 (history)  
Form: Version 1.0  
Age: 11.0  
Gender: Female  
Location: Foreign  
   Days after vaccination:2
Submitted: 2013-03-07
   Days after onset:823
Entered: 2013-03-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Antibody test, Blood glucose increased, Blood immunoglobulin E increased, Blood immunoglobulin M increased, Diabetes mellitus, Polydipsia, Polyuria, Streptococcus test, Streptococcus test negative
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Retroperitoneal fibrosis (broad), Hypersensitivity (narrow), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data: On 11-Dec-2010: Antistreptolysin titre, 284 IU; Blood glucose, 583; IgM, 248 IU; IgE 233,9 IU; Antigiladin antibody, IgG 14 IU; Fasting blood glucose 264 mg; Blood immunoglobulin M, 248 IU; 12/11/2010, Streptococcus test, 284 IU
CDC Split Type: WAES1303ITA002329

Write-up: Case received from Health Authority (case n. 195155) on 04-MAR-2013 through SPMSD. Case initially reported by a physician. Case medically confirmed. An 11 year old female patient was vaccinated on 03-DEC-10 with the third dose of GARDASIL (batch n. NM06870, lot number NJ53440, expiration date 31-DEC-2011) i.m. On 05-DEC-10 she presented with polydypsia and polyuria. She was admitted to the hospital and diagnosed with diabetes mellitus and treated with insulin. Labwork performed: see lab comments screen. The outcome is not recovered. The case is closed.

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