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新冠病毒感染后巨细胞动脉炎病程中的动脉炎性前部缺血性视神经病变

Arteritic Anterior Ischemic Optic Neuropathy in the Course of Giant Cell Arteritis After COVID-19.

作者信息

Szydełko-Paśko Urszula, Przeździecka-Dołyk Joanna, Kręcicka Julia, Małecki Rafał, Misiuk-Hojło Marta, Turno-Kręcicka Anna

机构信息

Department of Ophthalmology, Wrocław Medical University, Wrocław, Poland.

Department of Optics and Photonics, Wrocław University of Science and Technology, Wrocław, Poland.

出版信息

Am J Case Rep. 2022 Jan 11;23:e933471. doi: 10.12659/AJCR.933471.

Abstract

BACKGROUND Giant cell arteritis (GCA) is an inflammation of large vessels that affects the lining of the arteries and leads to vessel swelling and the eventual reduction of blood flow. This can result in ischemia of the optic nerve, which is known as arteritic anterior ischemic optic neuropathy (AAION). The present case seems noteworthy because the patient developed GCA with the ocular manifestation of AAION shortly after having COVID-19. CASE REPORT A 69-year-old woman was admitted to the Clinic of Ophthalmology after having COVID-19. She reported vision loss in the left eye, which appeared 2.5 weeks after a positive SARS-CoV-2 test. While in the hospital, she was diagnosed with AAION and GCA. The patient was treated with enoxaparin sodium, prednisone, and methotrexate. Three months after the hospitalization, the visual acuity of the left eye was limited to light perception, and optic nerve atrophy was reported. CONCLUSIONS We would like to emphasize the role of SARS-CoV-2 infection as a possible risk factor for the onset of GCA and its ocular manifestations, such as AAION. However, further research is needed to determine the relationship between SARS-CoV-2 infection and GCA. Because some symptoms of the 2 diseases are similar, the diagnosing process might be long and challenging. The diagnosis of GCA should be made as soon as possible to avoid serious complications, such as bilateral vision loss.

摘要

背景

巨细胞动脉炎(GCA)是一种大血管炎症,会影响动脉内膜,导致血管肿胀并最终使血流减少。这可能导致视神经缺血,即动脉炎性前部缺血性视神经病变(AAION)。本病例似乎值得关注,因为该患者在感染新冠病毒后不久就出现了伴有AAION眼部表现的GCA。

病例报告

一名69岁女性在感染新冠病毒后入住眼科诊所。她报告称左眼视力丧失,在新冠病毒检测呈阳性2.5周后出现。住院期间,她被诊断为AAION和GCA。患者接受了依诺肝素钠、泼尼松和甲氨蝶呤治疗。住院三个月后,左眼视力仅存光感,且报告出现视神经萎缩。

结论

我们想强调新冠病毒感染作为GCA发病及其眼部表现(如AAION)的可能危险因素的作用。然而,需要进一步研究以确定新冠病毒感染与GCA之间的关系。由于这两种疾病的一些症状相似,诊断过程可能漫长且具有挑战性。应尽快诊断GCA以避免严重并发症,如双眼视力丧失。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f74/8762612/ade57127c108/amjcaserep-23-e933471-g001.jpg

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