Abstract:
Coronavirus disease (COVID-19) vaccines have demonstrated excellent efficacy in reducing the morbidity and severity of the disease. However, some patients have been reported to develop systemic rheumatic diseases, such as rheumatoid arthritis, myocarditis, Guillain-Barre syndrome, and giant cell arteritis (GCA) following COVID-19 vaccination. We present a case of GCA with ischemic optic neuropathy following COVID-19 mRNA vaccination. A 73-year-old woman developed headache, myalgia, scalp tenderness, and jaw claudication 4 days after her seventh dose of the vaccination; she also developed severe visual disturbances 1 month after the vaccination. The blood examination tests showed an increased serum C-reactive protein level and erythrocyte sedimentation rate. The echogram for the temporal artery showed a halo sign. Ophthalmic examination revealed ischemic optic neuropathy in both eyes. The patient was treated with a high-dose glucocorticoid and tocilizumab under the diagnosis of GCA with ischemic optic neuropathy, obtaining mild improvement of the symptoms. This report underscores the need for clinical vigilance and further data collection regarding GCA cases after COVID-19 vaccination.
摘要:
冠状病毒病(COVID-19)疫苗在降低疾病的发病率和严重程度方面表现出优异的功效。然而,据报道,一些患者患有全身性风湿病,比如类风湿性关节炎,心肌炎,格林-巴利综合征,和COVID-19疫苗接种后的巨细胞动脉炎(GCA)。我们介绍了一例COVID-19mRNA疫苗接种后GCA伴缺血性视神经病变的病例。一名73岁的妇女出现头痛,肌痛,头皮压痛,第7次接种疫苗后4天,颌骨跛行;接种疫苗后1个月,她还出现了严重的视力障碍。血液检查检查显示血清C反应蛋白水平和红细胞沉降率升高。颞动脉的超声图显示有晕征。眼科检查显示双眼缺血性视神经病变。在GCA诊断为缺血性视神经病变的情况下,患者接受大剂量糖皮质激素和托珠单抗治疗,获得症状的轻度改善。该报告强调了对COVID-19疫苗接种后GCA病例的临床警惕和进一步数据收集的必要性。