이상반응 보고
| VAERS ID | 2000663 |
|---|---|
| 성별 | 남성 |
| 나이 | |
| 주 코드 | FR |
| 제약회사 | JANSSEN |
| 로트 번호 | XE395 |
| 예방접종 횟수 | 1 |
| 접종일 | |
| 발병일 | 2021-11-18 |
| 상태 | 입원 사망 |
증상
- 실험실 테스트(Laboratory test)
- 면역성 혈소판 감소증(Immune thrombocytopenia)
- 폐 색전증(Pulmonary embolism)
- 뇌출혈(Cerebral haemorrhage)
- 파종 성 혈관 내 응고(Disseminated intravascular coagulation)
- 동맥폐쇄성 질환(Arterial occlusive disease)
- 혈소판 감소 증후군을 동반한 혈전증(Thrombosis with thrombocytopenia syndrome)
이환 중 질병
지병
Medical History/Concurrent Conditions: Alcohol use; Drug abuser; Comments: Unknown
기타 의료
이전 예방접종
알레르기
임상 검사
Test Date: 20211121; Test Name: Lab test; Result Unstructured Data: detection of antibodies
증상 상세
CONSUMPTIVE COAGULOPATHY; THROMBOSIS WITH THROMBOCYTOPENIA SYNDROME; HAEMORRHAGE INTRACEREBRAL; PULMONARY EMBOLISM; ARTERIAL OCCLUSION; IMMUNE THROMBOCYTOPENIA; This spontaneous report received from a physician by a Regulatory Authority (DE-PEI-202100275115) on 03-JAN-2022 and concerned a 38 year old male.
The patient's weight was 65 kilograms, and height was 175 centimeters.
The patient's concurrent conditions included: drug abuser, and alcohol use.
The patient received covid-19 vaccine ad26.
cov2.
s (suspension for injection, route of admin not reported, batch number: XE395, expiry: UNKNOWN) 0.
5 ml, start therapy date was not reported, 1 total for an unspecified indication (Dose number in series 1).
No concomitant medications were reported.
On 18-NOV-2021, the patient experienced consumptive coagulopathy, thrombosis with thrombocytopenia syndrome, haemorrhage intracerebral, pulmonary embolism, arterial occlusion, immune thrombocytopenia and was hospitalized for unspecified date.
On 21-NOV-2021, Laboratory data included: Lab test (NR: not provided) Detection of PF4/ heparin IgG antibodies On an unspecified date, the patient died from unknown cause of death.
An autopsy was not performed.
The action taken with covid-19 vaccine ad26.
cov2.
s was not applicable.
The patient died of consumptive coagulopathy, thrombosis with thrombocytopenia syndrome, haemorrhage intracerebral, pulmonary embolism, arterial occlusion and immune thrombocytopenia on an unspecified date.
This report was serious (Death, and Hospitalization Caused / Prolonged).
Additional information was received from a physician on 03-JAN-2022 .
The following information was updated and incorporated into the case narrative: Event and outcome of immune thrombocytopenia added.
; Reporter's Comments: Measures: decompressive hemicraniectomy and intracranial pressure therapy, intensive therapy; Reported Cause(s) of Death: UNKNOWN CAUSE OF DEATH