COVID-19 mRNA Vaccine–Associated Uveitis Leading to Diagnosis of Sarcoidosis: Case Report and Review of Literature

Matsuo, Toshihiko; Honda, Hiroyuki; Tanaka, Takehiro; Uraguchi, Kensuke; Kawahara, Masaaki; Hagiya, Hideharu

doi:10.1177/23247096221086450

Permalink : http://escholarship.lib.okayama-u.ac.jp/63291

ID	63291
FullText URL	fulltext20220330-2.pdf 639 KB
Author	Matsuo, Toshihiko Graduate School of Interdisciplinary Science and Engineering in Health Systems, Okayama University, Japan ORCID Kaken ID publons researchmap Honda, Hiroyuki Department of General Medicine, Okayama University Hospital, Japan Tanaka, Takehiro Department of Pathology, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Japan ORCID Kaken ID publons Uraguchi, Kensuke Department of Otolaryngology, Head & Neck Surgery, Okayama University Hospital, Japan Kawahara, Masaaki Kawahara Eye Clinic, Okayama, Japan Hagiya, Hideharu Department of General Medicine, Okayama University Hospital, Japan ORCID Kaken ID researchmap
Abstract	A 34-year-old Japanese person with male gender identity who had been taking intramuscular injection of methyltestosterone depot for 11 years after bilateral mastectomy noticed blurred vision 5 days after the second vaccination for COVID-19 (Tozinameran; Pfizer-BioNTech) in the interval of 3 weeks following the first vaccination. The patient was diagnosed as granulomatous iritis with mutton-fat keratic precipitates and small iris nodules at the pupillary margin in the right eye and began to have 0.1% betamethasone eye drops with good response. The patient, however, continued to have fever and malaise and showed a high level of serum soluble interleukin-2 receptor (sIL-2R) even 4 weeks after the second vaccination. Computed tomographic scan disclosed mediastinal and bilateral hilar small lymphadenopathy together with limited granular lesion in the right lung. Gallium-67 scintigraphy demonstrated high uptake not only in mediastinal and hilar lymph nodes but also in bilateral parotid glands. Right parotid gland biopsy revealed noncaseating granulomas and proved pathological diagnosis of sarcoidosis. The systemic symptoms were relieved by oral prednisolone 20 mg daily. Even though the causal relationship remains undetermined, this case is unique at the point that vaccine-associated uveitis led to the detection of pulmonary lesions and lymphadenopathy, resulting in clinical and pathological diagnosis of sarcoidosis. In literature review, 3 patients showed sarcoidosis-like diseases after COVID-19 vaccination: 2 patients were diagnosed clinically as Lofgren syndrome with acute onset of erythema nodosum and ankle swelling, with or without mediastinal and hilar lymphadenopathy, whereas 1 patient with mediastinal lymphadenopathy but no uveitis was diagnosed pathologically by biopsy as sarcoidosis.
Published Date	2022-01
Publication Title	Journal of Investigative Medicine High Impact Case Reports
Volume	volume10
Publisher	SAGE Publications
Start Page	1
End Page	7
ISSN	2324-7096
Content Type	Journal Article
language	English
OAI-PMH Set	岡山大学
File Version	publisher
PubMed ID	35313760
DOI	10.1177/23247096221086450
Related Url	isVersionOf https://doi.org/10.1177/23247096221086450
License	https://creativecommons.org/licenses/by-nc/4.0/
Citation	Matsuo T, Honda H, Tanaka T, Uraguchi K, Kawahara M, Hagiya H. COVID-19 mRNA Vaccine–Associated Uveitis Leading to Diagnosis of Sarcoidosis: Case Report and Review of Literature. Journal of Investigative Medicine High Impact Case Reports. January 2022. doi:10.1177/23247096221086450