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COVID-19 期间伴或不伴肾小管间质性肾炎的类肉瘤样葡萄膜炎。

Sarcoid-like Uveitis with or without Tubulointerstitial Nephritis during COVID-19.

机构信息

Department of Ophthalmology, Ondokuz Mayıs University, Samsun, Turkey.

Department of Internal Medicine, Division of Rheumatology, Ondokuz Mayıs University, Samsun, Turkey.

出版信息

Ocul Immunol Inflamm. 2023 Apr;31(3):483-490. doi: 10.1080/09273948.2022.2032195. Epub 2022 Feb 24.

Abstract

PURPOSE

To report sarcoid-like uveitis with or without tubulointerstitial nephritis (TIN) during coronavirus disease 2019 (COVID-19) and to discuss diagnostic evaluation and treatment.

METHODS

Detailed information on the subject's demographics, medical history, ophthalmic examination findings, and laboratory results were obtained from medical records. Fluorescein angiography (FA) and indocyanine green angiography (ICGA) images were evaluated.

RESULTS

All seven patients aged between 8 and 17 had bilateral granulomatous panuveitis. TIN preceded in four patients. Thorax computed tomography of patient 1 was found to be compatible with COVID-19, patients 2 and 3 were in contact with Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive parents, patients 4 and 5 were found to be SARS-CoV-2 PCR positive, and patients 6 and 7 were positive for SARS-CoV-2 IgG antibodies. ICGA revealed hypofluorescent dots in six patients. Intraocular inflammation was controlled with corticosteroid and/or immunomodulatory therapy. Visual acuity was maintained or improved in all.

CONCLUSION

SARS-CoV-2 infection may be related to sarcoid-like uveitis and acute tubulointerstitial nephritis.

摘要

目的

报告 COVID-19 期间伴或不伴肾小管间质性肾炎(TIN)的类肉瘤样葡萄膜炎,并讨论其诊断评估和治疗。

方法

从病历中获取了受试者的人口统计学、病史、眼科检查结果和实验室结果的详细信息。评估了荧光素血管造影(FA)和吲哚青绿血管造影(ICGA)图像。

结果

7 名年龄在 8 至 17 岁之间的患者均患有双侧肉芽肿性全葡萄膜炎。在 4 名患者中,TIN 先于葡萄膜炎发生。患者 1 的胸部计算机断层扫描与 COVID-19 相符,患者 2 和 3 与 SARS-CoV-2 阳性父母有接触,患者 4 和 5 被检测出 SARS-CoV-2 PCR 阳性,患者 6 和 7 则 SARS-CoV-2 IgG 抗体阳性。6 名患者的 ICGA 显示出低荧光点。通过皮质类固醇和/或免疫调节治疗控制眼内炎症。所有患者的视力均保持或提高。

结论

SARS-CoV-2 感染可能与类肉瘤样葡萄膜炎和急性肾小管间质性肾炎有关。

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