第七剂 COVID-19 mRNA 疫苗接种后新发巨细胞动脉炎伴缺血性视神经病变:病例报告和文献综述。

IF 0.9 Q4 RHEUMATOLOGY Modern rheumatology case reports Pub Date : 2024-08-03 DOI:10.1093/mrcr/rxae042
Shin-Ichiro Ohmura, Haruka Yonezawa, Toshitaka Yukishima, Yuko Gohto, Akira Obana
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引用次数: 0

摘要

冠状病毒病(COVID-19)疫苗在降低该病的发病率和严重程度方面表现出卓越的功效。然而,据报道,一些患者在接种 COVID-19 疫苗后会出现全身性风湿性疾病,如类风湿性关节炎、心肌炎、格林-巴利综合征和巨细胞动脉炎(GCA)。我们报告了一例接种 COVID-19 mRNA 疫苗后出现 GCA 并伴有缺血性视神经病变的病例。一名 73 岁的妇女在接种第 7 剂疫苗 4 天后出现头痛、肌痛、头皮触痛和下颌跛行;接种 1 个月后还出现了严重的视力障碍。血液检查结果显示血清 C 反应蛋白水平和红细胞沉降率升高。颞动脉回声图显示有晕轮征。眼科检查显示双眼缺血性视神经病变。在诊断为 GCA 并发缺血性视神经病变的情况下,患者接受了大剂量糖皮质激素和托珠单抗治疗,症状得到轻度改善。该报告强调了临床警惕性和进一步收集 COVID-19 疫苗接种后 GCA 病例数据的必要性。
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New-onset of giant cell arteritis with ischemic optic neuropathy following the seventh-dose of COVID-19 mRNA vaccination: A case report and literature review.

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.

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