Vogt-Koyanagi-Harada综合征可能与COVID-19疫苗接种相关:病例报告和文献综述

IF 2.9 Q3 IMMUNOLOGY
Zhiqiang Cui, Yan Luo, Yanli Yi, Xuli Guo, Yuqi Liu, Xiang Wang, Xiaonan Liu
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引用次数: 0

摘要

研究COVID-19疫苗接种与Vogt-Koyanagi-Harada (VKH)综合征之间的潜在关联,为疫苗相关眼部疾病的诊断和管理提供新的见解。结合文献回顾进行了病例报告。分析了一名19岁男性在接种第二剂COVID-19灭活疫苗后出现VKH的病例。评估临床特征、治疗结果(糖皮质激素治疗伴2年随访)和基于文献的比较。系统回顾pubmed索引的疫苗相关VKH病例,并使用Naranjo药物不良反应概率量表评估因果关系。患者在接种疫苗后14天出现双侧视力模糊,通过荧光素血管造影(FFA)和光学相干断层扫描(OCT)诊断为视网膜神经上皮脱离的VKH。口服强的松(60mg /天,逐渐减少)使视力恢复到接近正常水平(OD: 20/40, OS: 20/33),与患者报告的基线视力一致。8周内随访无复发。文献分析显示,疫苗相关的VKH症状通常在接种疫苗后8天出现,与世卫组织的40天不良事件监测窗口一致。纳兰霍评分为4分表明可能是疫苗引发的免疫反应。COVID-19疫苗可能通过免疫失调机制诱导VKH,特别是在遗传易感个体中。虽然因果关系仍未得到证实,但临床医生应对接种后的急性双侧葡萄膜炎保持警惕。糖皮质激素治疗在缓解症状和预防复发方面有疗效。加强对疫苗相关眼部不良事件的主动监测和机制研究是必要的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Vogt-Koyanagi-Harada syndrome potentially associated with COVID-19 vaccination: a case report and literature review.

To investigate the potential association between COVID-19 vaccination and Vogt-Koyanagi-Harada (VKH) syndrome, offering novel insights for the diagnosis and management of vaccine-related ocular disorders. A case report combined with a literature review was conducted. A 19-year-old male developing VKH after receiving the second dose of an inactivated COVID-19 vaccine was analyzed. Clinical features, treatment outcomes (glucocorticoid therapy with 2-year follow-up), and literature-based comparisons were evaluated. PubMed-indexed cases of vaccine-associated VKH were systematically reviewed, and causality was assessed using the Naranjo Adverse Drug Reaction Probability Scale. The patient presented with bilateral blurred vision 14 days post-vaccination, diagnosed as VKH with retinal neuroepithelial detachment via fluorescein angiography (FFA) and optical coherence tomography (OCT). Oral prednisone (starting at 60 mg/day, tapered gradually)restored visual acuity to near-normal levels (OD: 20/40, OS: 20/33), consistent with the patient's reported baseline vision. Within 8 weeks, with no recurrence during follow-up. Literature analysis revealed vaccine-associated VKH symptoms typically emerged at a median of 8 days post-vaccination, aligning with the WHO's 40-day adverse event monitoring window. A Naranjo score of 4 indicated a probable vaccine-triggered immune response. COVID-19 vaccines may induce VKH via immune dysregulation mechanisms, particularly in genetically predisposed individuals. Although causality remains unconfirmed, clinicians should maintain vigilance for acute bilateral uveitis post-vaccination. Glucocorticoid therapy demonstrates efficacy in symptom resolution and relapse prevention. Enhanced active surveillance and mechanistic studies on vaccine-related ocular adverse events are warranted.

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来源期刊
Immunological Medicine
Immunological Medicine Medicine-Immunology and Allergy
CiteScore
7.10
自引率
2.30%
发文量
19
审稿时长
19 weeks
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