Received May 8, 2026
| Type | Name | Manufacturer | Dose | Lot | Route / Site |
|---|---|---|---|---|---|
| FLU3 | INFLUENZA (SEASONAL) (FLUCELVAX) | SEQIRUS, INC. | UNK | 407009 | SYR / LA |
Bilateral bicept, forarm, shoulder and neck pain.
None
HIV
None
None
12/02/25 ? Statin discontinued, likely in response to new musculoskeletal symptoms. 12/07/25 ? Treated with Methylprednisolone (corticosteroid) for inflammatory symptoms. 12/17/25 ? Laboratory workup performed; results within normal limits at that time. 02/17/26 ? Orthopedic evaluation with X-rays; no structural abnormality identified by orthopedic surgeon or neurosurgeon. 02/19/26 ? MRI performed. 02/24/26 ? Nerve conduction study (NCS) and EMG performed; no neurological abnormality identified. 03/04/26 ? Rheumatology consultation with comprehensive laboratory panel. ACE (angiotensin-converting enzyme) level markedly elevated at 330 U/L (reference range approximately 8?52 U/L), raising strong concern for systemic sarcoidosis. 04/20/26 ? Follow-up consultation with neurosurgeon; reviewed MRI findings and determined no structural or neurological abnormality sufficient to account for the patient's ongoing symptoms. 05/12/26 ? PET-CT scan scheduled as next diagnostic step to evaluate for sarcoidosis versus other granulomatous or lymphoproliferative disease. Treating physicians' assessment: Rheumatology and collaborating physicians consider the influenza vaccine a likely precipitating vector for the development of systemic sarcoidosis in this patient.