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新型冠状病毒肺炎感染后并发急性间质性肾炎及疑似葡萄膜炎-小柳原田病:一例报告

Acute interstitial nephritis and probable Vogt-Koyanagi-Harada disease following COVID-19 infection: a case report.

作者信息

Aslani Nahid, Malekahmadi Mohammad, Merrikhi Alireza, Gheisari Alaleh, Mardani Aida, Afshar Kimia

机构信息

Department of Pediatric Rheumatology, Isfahan University of Medical Sciences, Isfahan, Iran.

Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran.

出版信息

J Med Case Rep. 2025 Jul 1;19(1):303. doi: 10.1186/s13256-025-05357-1.

Abstract

INTRODUCTION

Vogt-Koyanagi-Harada disease is an autoimmune inflammatory disease characterized by bilateral serous retinal detachment, which viral infections might induce. Coronavirus disease 2019 infection is thought to cause numerous autoimmune and inflammatory disorders. We report a case of Vogt-Koyanagi-Harada disease post-coronavirus disease 2019 infection in the pediatric population.

CASE PRESENTATION

A 9-year-old Iranian girl with positive severe acute respiratory syndrome coronavirus 2 reverse transcription polymerase chain reaction presented with an elevated serum creatinine level due to acute interstitial nephritis that was treated with a high dose of corticosteroid. During corticosteroid tapering, she complained of reduced visual acuity in her right eye. After evaluation and imaging, diagnosis of unilateral Vogt-Koyanagi-Harada disease was made, and the patient was successfully treated with high-dose corticosteroid, methotrexate, and antitumor necrosis factor α.

CONCLUSION

Coronavirus disease 2019 infection could be a possible trigger factor for acute interstitial nephritis and Vogt-Koyanagi-Harada disease. Early diagnosis and treatment of these autoimmune features with corticosteroids and other antiinflammatory agents can help in faster improvement in these patients. In addition, it is crucial for physicians to consider Vogt-Koyanagi-Harada disease in pediatrics as one of the coronavirus disease 2019 complications for early diagnose and current treatment.

摘要

引言

伏格特-小柳-原田病是一种自身免疫性炎症性疾病,其特征为双侧浆液性视网膜脱离,病毒感染可能诱发该病。2019冠状病毒病感染被认为会引发多种自身免疫性和炎症性疾病。我们报告一例儿科患者在感染2019冠状病毒病后发生伏格特-小柳-原田病的病例。

病例介绍

一名9岁伊朗女孩严重急性呼吸综合征冠状病毒2逆转录聚合酶链反应检测呈阳性,因急性间质性肾炎导致血清肌酐水平升高,接受了高剂量皮质类固醇治疗。在逐渐减少皮质类固醇剂量期间,她抱怨右眼视力下降。经评估和影像学检查后,诊断为单侧伏格特-小柳-原田病,患者通过高剂量皮质类固醇、甲氨蝶呤和抗肿瘤坏死因子α成功治愈。

结论

2019冠状病毒病感染可能是急性间质性肾炎和伏格特-小柳-原田病的触发因素。早期使用皮质类固醇和其他抗炎药物诊断和治疗这些自身免疫特征有助于这些患者更快康复。此外,对于儿科医生来说,将伏格特-小柳-原田病视为2019冠状病毒病的并发症之一以便早期诊断和及时治疗至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c9c8/12220733/66ce28813513/13256_2025_5357_Fig1_HTML.jpg

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