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VAERS Report 2136755

Case Report Section

Détails du rapport Vaer

Âge: N/A

Genre: Male

Région : Outside US

Patient décédé?
Non
Renseignements sur les vaccins

Nom: COVID19 (COVID19 (PFIZER-BIONTECH))

Type : Coronavirus 2019 vaccine

Fabricant: PFIZER

Lot: fe1573


Date de réception du rapport
2022-02-24
Date à laquelle le formulaire est complèté
Date de vaccination
2021-07-03
Date d’apparition
0
Nombre de jours (date d’apparition – date de vaccination)
0
Description de l’événement indésirable

blood glucose increased; latent autoimmune diabetes in adults/ trigger for onset of type 1 diabetes; this is a spontaneous report received from a contactable reporter(s) (consumer or other non hcp) from the regulatory authority-web. the reporter is the patient. regulatory number: nl-lrb-00780561 (lrb). a 53 year-old male patient received bnt162b2 (comirnaty, solution for injection), administration date 03jul2021 (lot number: fe1573) as dose 2, single for covid-19 immunisation. relevant medical history included: "type 2 diabetes mellitus" (ongoing), notes: for years. the patient had no previous covid-19 infection. concomitant medication(s) included: metformine hcl. past drug history included: amoxicilline, reaction(s): "allergy to antibiotic". vaccination history included: comirnaty (dose 1), administration date: 29may2021, for covid-19 immunisation, reaction(s): "no adverse reaction". the following information was reported: latent autoimmune diabetes in adults (medically significant) with onset jul2021, outcome "not recovered", described as "latent autoimmune diabetes in adults/ trigger for onset of type 1 diabetes"; blood glucose increased (medically significant) with onset nov2021, outcome "not recovered", described as "blood glucose increased". the events "latent autoimmune diabetes in adults/ trigger for onset of type 1 diabetes" and "blood glucose increased" were evaluated at the physician office visit. the patient underwent the following laboratory tests and procedures: blood glucose value: (unspecified date) between 7 and 8, notes: stable; (nov2021) 11, notes: increased, at the next control visit for blood glucose and did not recover; blood test: (jul2021) diabetes type 1, notes: lada (latent autoimmune diabetes in adults) examination at the hospital. therapeutic measures were taken as a result of latent autoimmune diabetes in adults, blood glucose increased. the patient was treated with regular consult at internal medicine specialist, dietician, diabetes health care professional and medication (insulin). clinical course: latent autoimmune diabetes in adults: between 2 to 4 months after start during the period from july to november. no other possible causes beside the vaccination were known. no follow-up attempts are possible. no further information is expected

Données de laboratoire
test name: blood glucose value; result unstructured data: test result:between 7 and 8; comments: stable; test date: 202111; test name: blood glucose value; result unstructured data: test result:11; comments: increased, at the next control visit for blood glucose and did not recover; test date: 202107; test name: blood test; result unstructured data: test result:diabetes type 1; comments: lada (latent autoimmune diabetes in adults) examination at the hospital
Liste des symptômes
blood glucose increased blood test blood glucose latent autoimmune diabetes in adults
Patient décédé?
Non
Date de décès
N/A
Anomalie congénitale
false
Vaccin administré par :
Other
Vaccin acheté par :
Inconnu
Visite d’un patient à l’urgence?
Non
Patient hospitalisé?
Non
Séjour à l’hôpital
Non
Nombre de jours à l’hôpital
Non spécifié
Invalidité permanente?
Non
Allergies:
na
Maladie actuelle
type 2 diabetes mellitus (for years)