Somboonviboon Dujrath, Wattanathum Anan, Keorochana Narumon, Wongchansom Kittisak
Pulmonary and Critical Care Division, Department of Medicine Phramongkutklao Hospital Bangkok Thailand.
Ocular Immunology and Inflammation Division, Department of Ophthalmology Phramongkutklao Hospital Bangkok Thailand.
Respirol Case Rep. 2022 Aug 11;10(9):e01016. doi: 10.1002/rcr2.1016. eCollection 2022 Sep.
COVID-19 has been implicated in the development of a range of autoimmune diseases and medical consequences. Sarcoidosis is an inflammatory disease with sustained granulomatous inflammation. The possible main pathogenesis of sarcoidosis is a dysregulation between immune response and certain environmental antigens. We present a case of sarcoidosis as an interesting sequela of COVID-19. The patient was hospitalized due to SARS-CoV-2 without complication. Ten weeks after the illness, his chest computed tomography (CT) showed bilateral hilar, paratracheal and subcarinal lymph node enlargement. Endobronchial ultrasound with transbronchial needle aspiration (EBUS-TBNA) was performed; pathologic findings were that of well-formed non-necrotizing granulomas. Complete eye examination reported panuveitis and papillitis in both eyes. On the basis of these findings, sarcoidosis was diagnosed. Therefore, sarcoidosis developing after COVID-19 was suggested as a possible link between the viral infection and dysregulation of the inflammation process. However, further studies are needed to confirm this association.
新冠病毒(COVID-19)已被认为与一系列自身免疫性疾病及医学后果的发生有关。结节病是一种伴有持续性肉芽肿性炎症的炎性疾病。结节病可能的主要发病机制是免疫反应与某些环境抗原之间的调节异常。我们报告一例结节病作为COVID-19有趣后遗症的病例。该患者因感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)住院且无并发症。患病10周后,其胸部计算机断层扫描(CT)显示双侧肺门、气管旁及隆突下淋巴结肿大。进行了支气管内超声引导下经支气管针吸活检(EBUS-TBNA);病理结果为形成良好的非坏死性肉芽肿。全面眼部检查报告双眼全葡萄膜炎和视乳头炎。基于这些发现,诊断为结节病。因此,COVID-19后发生的结节病被认为是病毒感染与炎症过程调节异常之间的一个可能联系。然而,需要进一步研究来证实这种关联。