| VAERS ID: |
77518 (history) |
| Form: |
Version 1.0 |
| Age: |
17.0 |
| Sex: |
Female |
| Location: |
New York |
| Vaccinated: | 1995-04-03 |
| Onset: | 0000-00-00 |
| Submitted: |
1995-09-08 |
| Entered: |
1995-09-19 |
| Days after submission: | 11 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM |
420A6 / 1 |
LA / IM |
Administered by: Private Purchased by: Unknown
Symptoms: Alanine aminotransferase increased,
Arthralgia,
Aspartate aminotransferase increased,
Diabetes mellitus,
Headache,
Hepatic function abnormal,
Hyperglycaemia,
Pyrexia
SMQs:, Liver related investigations, signs and symptoms (narrow), Hyperglycaemia/new onset diabetes mellitus (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: SGOT 79; SGPT 1117; gamma gt 210; Blood sugar 533;
CDC Split Type:
Write-up: pt recv vax 3APR95 & devel arthralgia, fever, h/a & upon return to US was found to have DM; 14JUN95 was given meds; also had LFT-has diabetes mellitus |
