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Write-up: Information has been received regarding a case in litigation concerning a male child who on 10/13/94, at the age of 12 months was vaccinated with a dose of MMR II (lot 609861/1037W; batch 850672). It is alleged that following the vaccination the pt developed Asperger''s syndrome and bowel problems. Upon internal review the pt''s Asperger''s syndrome and bowel problems were considered to be other important medical events (OMIC). No further info is available. A 15-day follow up report received 3/10/2003 adds: Information has been received concerning a 13 month old male child with mild asthma, mild hydroureteronephrosis and a medical history of clicking hips, bilateral ureteric reflux, and meconium staining of the liquor during during, who on 10/13/1994 was vaccinated with a dose of measles virus vaccine live (+) mumps virus vaccine live (+) rubella virus vaccine live (second generation) (Lot #609861/1037W: Batch #950672 (diluent)). It is alleged that following the vaccination the pt developed Asperger''s syndrome, Attention Deficit Disorder with Hyperactivity, and Lymphoid Nodular Hyperplasia in the terminal ileum. Additional info was received and indicted that the pt was crying, screaming and writhing about on one afternoon during the week post vaccination. This was unusual, as the pt never behaved like this before. Within 6 weeks post vaccination, the pt began to pick up his toys one after the other, look at them and then throw them away. He was no longer playing appropriately with them. Also the pt was extremely restless. He was not seeking out the company of adults as he had done before. He started to throw heavy objects around the house. Also within 8 weeks, his speech patterns had changed and from conversational cadences to being less talkative and expressing himself in a kind of gibberish that did not sound like conversational attempts. Within 3 to 4 months, his sleep patterns completely changed. He now needed little sleep, during which he was restless and twitchy. Within approximately 6 months, the pt had developed an obsession with the same audio and videocassettes. He would play then 30 or 40 times over and over again. If they were turned off, he would scream for hours. Within 6 months, the pt was displaying many typical autistic traits. He had gradually begun hand wringing and having temper tantrums. He had also lost all of his eye contact gradually in the 6 months post vaccination. He did not want to be near familiar people and developed a severe dislike of strangers. He would arch his body and go completely rigid if he was somewhere that he was uncomfortable with. In February 1997, the pt was seen by a pediatrician and was diagnosed as having attention deficit disorder with hyperactivity. He was prescribed methylphenidate (RITALIN) which made his condition worse and so he was brought off it after 3 months. On 05/07/1998, the pt was diagnosed with Asperger''s syndrome. Following continuous bouts of constipation for a period of around 12 months, the pt was seen and referred by a general practitioner on 06/16/1999. The pt underwent a colonoscopy on 05/16/2000 and the specialist in pediatric gastroenterology made a diagnosis of Grade 2 lymphoid nodlar hyperplasia in his terminal ileum with loss of vascular pattern up to the transverse colon. During the same appointment, the pt underwent an OGD (oesophagogastroduodenoscopy) that showed normal oesophagus, minimal antral erythema and duodenal erythema in ''D1''. In an assessment performed on 05/01/1997, at the age of 3.5 years old, a physician indicated that the pt''s mother had non-insulin dependent diabetes and needed insulin during pregnancy. The pt was born vaginally at 40 weeks without problems after an induction. He was an easy baby, slept a lot and was breast-fed until 8 months. He began verbalizing at about a year old and had a few words by the age 0f 2. He was talking in sentences now. His parents could not remember when the pt began to sit, crawl, stand, or walk but fel
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