Shukla Amarendra Kumar, Peter Amrutha, Bhargava Jitendra Kishore, Arya Veerendra, Gupta Manish Kumar, Yadav Nishtha, Tiwari Pawan
Department of Pulmonary, Critical Care and Sleep Medicine, School of Excellence in Pulmonary Medicine, Netaji Subhash Chandra Bose Medical College, Jabalpur.
Department of Respiratory Medicine, School of Excellence in Pulmonary Medicine, Netaji Subhash Chandra Bose Medical College, Jabalpur.
Monaldi Arch Chest Dis. 2022 Jun 8;93(1). doi: 10.4081/monaldi.2022.2279.
Sarcoidosis is an idiopathic granulomatous disease and can virtually affect any organ system. Multiple factors, including tubercular antigens organic and environmental exposures, have been implicated in its pathogenesis. In addition to drugs, sarcoid-like reactions have been reported following varicella and influenza vaccination. Few reports of erythema nodosum and Lofgren syndrome have been reported after the COVID19 vaccination, though no histologic diagnosis was pursued in these cases. We herein report a case of sarcoidosis presenting with bilateral acute onset vision loss with a temporal association with COVID19 vaccination (ChadOx-1 n-COV, COVISHIELDTM). Symptoms started within two weeks of receiving the vaccine. Alternate causes for optic neuritis were excluded. Transbronchial lung biopsy showed the presence of non-caseating epithelioid cell granulomas. The patient received high-dose corticosteroids immediately after diagnosis, albeit with incomplete clinical improvement in vision on a three-month follow-up. In conclusion, we report a novel case of sarcoidosis-related optic neuritis following COVID19 vaccination.
结节病是一种特发性肉芽肿性疾病，几乎可累及任何器官系统。多种因素，包括结核抗原、有机和环境暴露，均与其发病机制有关。除药物外，水痘和流感疫苗接种后也有类结节病反应的报道。尽管在这些新冠病毒疫苗接种后出现结节性红斑和洛弗格伦综合征的病例中未进行组织学诊断，但相关报道较少。我们在此报告一例结节病患者，其在接种新冠病毒疫苗（ChadOx-1 n-COV，COVISHIELDTM）后双侧急性视力丧失，且时间上与之相关。症状在接种疫苗后两周内出现。排除了视神经炎的其他病因。经支气管肺活检显示存在非干酪样上皮样细胞肉芽肿。患者在诊断后立即接受了大剂量皮质类固醇治疗，尽管在三个月的随访中视力改善不完全。总之,我们报告了一例新冠病毒疫苗接种后结节病相关视神经炎的新病例。
