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This is VAERS ID 42124

Case Details

VAERS ID: 42124 (history)  
Form: Version 1.0  
Age: 55.0  
Sex: Female  
Location: Washington  
Vaccinated:0000-00-00
Onset:1991-11-01
Submitted: 0000-00-00
Entered: 1992-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Blood creatine phosphokinase increased, Dermatomyositis, Face oedema, Rash
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Myocardial infarction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (narrow)

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: ~ ()~~~In patient
Other Medications:
Current Illness:
Preexisting Conditions: no hx of allergy to eggs;
Allergies:
Diagnostic Lab Data: elevated CPK; EMG; musclebiopsy-nl biopsy;
CDC Split Type:

Write-up: Devel dermatopolymyositis 5 days p/flu vax; devel swollen face & rash;


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