| VAERS ID: |
77886 (history) |
| Form: |
Version 1.0 |
| Age: |
68.0 |
| Sex: |
Female |
| Location: |
Illinois |
| Vaccinated: | 1995-07-20 |
| Onset: | 1995-07-21 |
| Days after vaccination: | 1 |
| Submitted: |
1995-09-27 |
| Days after onset: | 68 |
| Entered: |
1995-10-03 |
| Days after submission: | 6 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| HEPA: HEP A (HAVRIX) / SMITHKLINE BEECHAM |
420A6 / 2 |
- / IM |
Administered by: Private Purchased by: Private
Symptoms: Blood alkaline phosphatase increased,
Diarrhoea,
Gastrointestinal disorder,
Hepatic function abnormal,
Jaundice,
Neoplasm malignant,
Pruritus,
Urine analysis abnormal
SMQs:, Liver related investigations, signs and symptoms (narrow), Cholestasis and jaundice of hepatic origin (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Pseudomembranous colitis (broad), Biliary system related investigations, signs and symptoms (narrow), Biliary tract disorders (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Non-haematological malignant tumours (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, ? days
Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 1AUG95 BilTOT 7.8; SOGT 109; SGPT 277; ALKPH 388; 3AUG95 BILTOT 8.5; SGOT 113; SGPT 293; ALKPH 397; hepatitis screen neg;
CDC Split Type: 950074901
Write-up: pt recvd vax 20JUL95 & w/in 24-48hrs following vax exp itching, diarrhea, darker urine, & was jaundiced when examined; pt was found to have elevated liver enzymes 01AUG95;MD demonstrated evidence of bile duct obstruction-bile duct stricture |
