Initial anterior uveitis event associated with recent novel SARS-CoV-2 (COVID-19) infection in the setting of HLA-B27

Pereira, Austin; Murtaza, Fahmeeda; Kaplan, Alon; Yan, Peng

doi:10.1016/j.ajoc.2022.101565

Cited by 7 publications

(6 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…They postulated that initial anterior uveitis attack in the setting of COVID-19 was dysregulation of inflammatory cells and mediators in a patient with baseline elevated risk for ocular inflammation. [ 11 ]…”

Section: Discussionmentioning

confidence: 99%

COVID-19 vaccination, dengue hepatitis, and recurrent unilateral anterior uveitis

Sanjay

Kawali

Mahendradas

2023

Indian Journal of Ophthalmology

View full text Add to dashboard Cite

A 36-year-old Asian Indian male presented with redness and pain in his right eye of 1 week duration. He was diagnosed to have right acute anterior uveitis and had a history of being admitted at a local hospital for dengue hepatitis a month earlier. He had been on adalimumab 40 mg three weekly once and oral methotrexate 20 mg/week for human leucocyte antigen (HLA) B27 spondyloarthropathy and recurrent anterior uveitis. Our patient had re-activation of his anterior chamber inflammation on three distinct occasions: first, 3 weeks following recovery from coronavirus disease 2019 (COVID-19), the second after the second dose of COVID-19 vaccination, and the third after recovery from dengue fever-associated hepatitis. We propose molecular mimicry and bystander activation as the postulated mechanisms for the re-activation of his anterior uveitis. In conclusion, patients with auto-immune diseases can have recurrent ocular inflammation following COVID-19 or its vaccination or dengue fever as seen in our patient. The anterior uveitis is usually mild and responds to topical steroids. Additional immuno-suppression may not be needed. Mild ocular inflammation following vaccination should not deter individuals from getting COVID-19 vaccination.

show abstract

Section: Discussionmentioning

confidence: 99%

COVID-19 vaccination, dengue hepatitis, and recurrent unilateral anterior uveitis

Sanjay

Kawali

Mahendradas

2023

Indian Journal of Ophthalmology

View full text Add to dashboard Cite

show abstract

“…Some inflammatory eye diseases, such as anterior uveitis and conjunctivitis, have been diagnosed in patients with COVID-19, including children [2,29,30,31,32,33,34,35,36,37,38,39,40,41,42].…”

Section: Eye Involvementmentioning

confidence: 99%

“…The patient underwent a one-week course of treatment with prednisolone 1% 6 times daily and atropine sulfate 1% twice daily with good effect. According to the authors, it is important to screen patients for HLA-B27 after an initial event of anterior uveitis if they have been infected with SARS-CoV-2, as they are at higher risk for ocular inflammatory dysregulation [32].…”

Section: Eye Involvementmentioning

confidence: 99%

Clinical and immune-related manifestations in patients with COVID-19

Doncheva - Dilova,

Boyadzhieva,

Stoilov

2023

RBJ

View full text Add to dashboard Cite

In late 2019 a previously unknown infection affected many people in China. The disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified as coronavirus disease 2019 (COVID-19). In a very short period of time, the virus spread worldwide, so on March 11, 2020, the World Health Organization (WHO) declared a pandemic. Various studies have focused on the risk factors and pathogenesis of the virus and have distinguished different phases of the disease (viremic, hyperinflammatory phase and phase of complications) characterized by a wide range of clinical manifestations. Most patients experience mild flu-like symptoms, but severe disease and even death are possible. The main clinical manifestations are of the respiratory system with lung involvement. Damage caused by COVID-19 is observed in various organs and systems (nervous, endocrine, cardiovascular, excretory system, gastrointestinal tract, liver, immune system, eyes, etc.). In some patients, some of the symptoms may persist for weeks or months after the onset of infection (so-called "long COVID", "post-acute COVID-19" and "post-COVID syndrome (PCS)"). Antiphospholipid syndrome, systemic vasculitis, myositis, arthritis, systemic lupus, skin manifestations, hematological involvement, neurological involvement (Guillain-Barre syndrome, transverse myelitis, etc.), optic neuritis, cardiovascular involvement, acute pancreatitis, glomerulonephritis, thyroiditis, anterior uveitis, conjunctivitis, etc. stand out among them. Unfortunately, children are hit hard by COVID-19. In them, the viral load of SARS-CoV-2 is greater than in adults. More than 700 cases of a unique multisystem inflammatory syndrome in children (MIS-C) characterized by clinical and laboratory manifestations similar to Kawasaki disease and toxic shock syndrome have been described. The disease is severe - about 73% require intensive care, and the overall mortality is about 1.7%. Clinical criteria, laboratory parameters, analysis of blood oxygen saturation, imaging studies and RT-PCR (diagnostic gold standard) are used for the diagnosis of COVID-19. In patients with COVID-19, an individualized therapeutic approach is required. Since the beginning of the pandemic, affected countries have tried to flatten the epidemiological curve and avoid overloading health care systems by imposing specific hygiene measures, limiting social contact, wearing a mask, physical distance, travel restrictions, border closures, national lockdowns and mandatory quarantine for the infected and their contacts. In a short period of time, many highly effective vaccines have been developed, most with mild side effects after administration. Unfortunately, more severe reactions are possible after vaccination, but nevertheless the benefit outweighs the risk. This review aims to present the main clinical manifestations in patients with COVID-19 and the possible complications or post-covid syndromes.

show abstract

“…Research has demonstrated that HLA molecules can affect the severity and duration of viral infection [56]. Case reports of Sars-2-cov infection capable of triggering a reactive arthritis and uveitis in an HLA B27 positive patient exists [57,58]. Other research suggests that Sars 2-Cov might have a predilection for people with certain HLA phenotypes [59].…”

Section: Infections and Microbiomementioning

confidence: 99%

Ankylosing Spondylitis Pathogenesis and Pathophysiology

Alexander¹

2023

Ankylosing Spondylitis - Recent Concepts

View full text Add to dashboard Cite

The pathogenesis and pathophysiology of Ankylosing Spondylitis (AS) is complex and remains only partially understood. Contributory genes including a variety of HLA-B27 subset genes and many other non-HLA genes are implicated in the literature. Novel genes and gene–gene interactions being a continuously evolving area of AS research. Dysregulation of the enteric microbiome with a corresponding aberrant immunological response is recognised in research. Certain infectious agents are thought to play a role. A variety of other influences including environmental exposures, dietary and lifestyle factors and sex hormones appear to play a role in AS pathogenesis. There is emerging evidence that that pathophysiological response in AS is an elaborate combination of both autoinflammatory and autoimmune components, however the IL-17/IL-23 pathway remains the major pathway in AS according to studies to date. The specific mechanisms that lead to characteristic clinical features of AS including sacroiliitis, spondylitis, ankylosis, uveitis and other extra articular manifestations remain occult. Further research to establish these is ongoing.

show abstract

Initial anterior uveitis event associated with recent novel SARS-CoV-2 (COVID-19) infection in the setting of HLA-B27

Cited by 7 publications

References 15 publications

COVID-19 vaccination, dengue hepatitis, and recurrent unilateral anterior uveitis

COVID-19 vaccination, dengue hepatitis, and recurrent unilateral anterior uveitis

Clinical and immune-related manifestations in patients with COVID-19

Ankylosing Spondylitis Pathogenesis and Pathophysiology

Contact Info

Product

Resources

About