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Case report: Bilateral panuveitis resembling Vogt-Koyanagi-Harada disease after second dose of BNT162b2 mRNA COVID-19 vaccine.
Sato, Tomohito; Nihei, Ryotaro; Sora, Daisuke; Nishio, Yoshiaki; Takeuchi, Masaru.
  • Sato T; Department of Ophthalmology, National Defense Medical College, Saitama, Japan.
  • Nihei R; Department of Ophthalmology, National Defense Medical College, Saitama, Japan.
  • Sora D; Department of Ophthalmology, National Defense Medical College, Saitama, Japan.
  • Nishio Y; Department of Ophthalmology, National Defense Medical College, Saitama, Japan.
  • Takeuchi M; Department of Ophthalmology, National Defense Medical College, Saitama, Japan.
Front Immunol ; 13: 967972, 2022.
Article in English | MEDLINE | ID: covidwho-2080147
ABSTRACT
Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains a serious pandemic. COVID-19 vaccination is urgent needed for limiting SARS-CoV-2 outbreaks by herd immunity. Simultaneously, post-marketing surveillance to assess vaccine safety is important, and collection of vaccine-related adverse events has been in progress. Vision-threatening ophthalmic adverse events of COVID-19 vaccines are rare but are a matter of concern. We report a 45-year-old Japanese male with positive for HLA-DR4/HLA-DRB1*0405, who developed bilateral panuveitis resembling Vogt-Koyanagi-Harada (VKH) disease after the second dose of Pfizer-BioNTech COVID-19 mRNA (BNT162b2) vaccine. Glucocorticosteroid (GC) therapy combined with cyclosporine A (CsA) readily improved the panuveitis. The immune profile at the time of onset was analyzed using CyTOF technology, which revealed activations of innate immunity mainly consisting of natural killer cells, and acquired immunity predominantly composed of B cells and CD8+ T cells. On the other hand, the immune profile in the remission phase was altered by GC therapy with CsA to a profile composed primarily of CD4+ cells, which was considerably similar to that of the healthy control before the vaccination. Our results indicate that BNT162b2 vaccine may trigger an accidental immune cross-reactivity to melanocyte epitopes in the choroid, resulting in the onset of panuveitis resembling VKH disease.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Panuveitis / Uveomeningoencephalitic Syndrome / COVID-19 Type of study: Case report / Diagnostic study / Observational study / Randomized controlled trials Topics: Vaccines Limits: Humans / Male / Middle aged Language: English Journal: Front Immunol Year: 2022 Document Type: Article Affiliation country: Fimmu.2022.967972

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Panuveitis / Uveomeningoencephalitic Syndrome / COVID-19 Type of study: Case report / Diagnostic study / Observational study / Randomized controlled trials Topics: Vaccines Limits: Humans / Male / Middle aged Language: English Journal: Front Immunol Year: 2022 Document Type: Article Affiliation country: Fimmu.2022.967972