COVID-19 在系统性类固醇治疗 Vogt-Koyanagi-Harada 病时发生：一例报告。
COVID-19 Developed During Systemic Steroid Therapy for Vogt-Koyanagi-Harada Disease: A Case Report.
机构信息
Department of Ophthalmology, Tokyo Medical University, Tokyo, Japan.
出版信息
Ocul Immunol Inflamm. 2023 Aug;31(6):1305-1309. doi: 10.1080/09273948.2023.2200488. Epub 2023 Apr 21.
PURPOSE
The use of immunomodulatory therapy in the setting of coexistence of uveitis and coronavirus disease (COVID-19) remains controversial. We report a case of COVID-19 during systemic steroid therapy for Vogt-Koyanagi-Harada disease (VKH).
CASE REPORT
A 43-year-old female was diagnosed with VKH and started on steroid pulse therapy (1,000 mg/day) followed by high-dose oral corticosteroids. Two weeks after discharge from the hospital, she was readmitted to the intensive care unit with severe acute respiratory syndrome due to SARS-CoV-2 infection confirmed by PCR test, and fortunately both VKH and COVID-19-induced respiratory disease improved.
CONCLUSION
Given the absence of international agreement on how to manage COVID-19 patients with steroid-dependent VKH, existing clinical guidelines should be reviewed thoroughly to formulate useful strategies for managing VKH patients on steroid treatment who contract COVID-19. Furthermore, the outcomes of patients with steroid-dependent autoimmune uveitis including VKH who develop COVID-19 should be analyzed.
目的
在葡萄膜炎和冠状病毒病（COVID-19）共存的情况下使用免疫调节疗法仍存在争议。我们报告了一例 COVID-19 病例，该患者在系统性类固醇治疗 Vogt-Koyanagi-Harada 病（VKH）期间感染了 COVID-19。
病例报告
一名 43 岁女性被诊断为 VKH，并开始接受类固醇脉冲治疗（1000mg/天），随后接受高剂量口服皮质类固醇治疗。出院两周后，她因 SARS-CoV-2 感染导致严重急性呼吸综合征而再次入住重症监护病房，PCR 检测结果证实感染了 COVID-19，幸运的是，VKH 和 COVID-19 引起的呼吸疾病都有所改善。
结论
鉴于目前尚无关于如何管理依赖类固醇的 COVID-19 患者 VKH 的国际共识，应彻底审查现有的临床指南，为接受类固醇治疗的 VKH 患者制定应对 COVID-19 的有用策略。此外，应分析发生 COVID-19 的依赖类固醇的自身免疫性葡萄膜炎（包括 VKH）患者的结局。
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