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Sarcoid-like Uveitis with or without Tubulointerstitial Nephritis during COVID-19
Hilal Eser-Ozturk1, Tugba Izci Duran2, Ozlem Aydog3
1Department of Ophthalmology, Ondokuz Mayıs University, Samsun, Turkey.
Ocular Immunology and Inflammation
|February 24, 2022
Summary
Coronavirus disease 2019 (COVID-19) may cause sarcoid-like uveitis and acute tubulointerstitial nephritis in children. Early diagnosis and treatment with corticosteroids and immunomodulatory therapy helped maintain or improve vision.
Area of Science:
- Ophthalmology
- Nephrology
- Infectious Diseases
Background:
- Sarcoid-like uveitis and tubulointerstitial nephritis (TIN) are inflammatory conditions.
- The association between these conditions and coronavirus disease 2019 (COVID-19) requires further investigation.
Purpose of the Study:
- To report cases of sarcoid-like uveitis with or without TIN in pediatric patients during COVID-19.
- To discuss the diagnostic evaluation and treatment strategies for these cases.
Main Methods:
- Retrospective review of medical records for seven pediatric patients (ages 8-17).
- Analysis of ophthalmic examination findings, laboratory results, and imaging studies including fluorescein angiography (FA) and indocyanine green angiography (ICGA).
- Assessment of COVID-19 status through PCR, antibody testing, or contact tracing.
Main Results:
- All seven patients presented with bilateral granulomatous panuveitis; four had preceding TIN.
- COVID-19 infection or exposure was confirmed in all patients via various methods (CT scan, contact, PCR, IgG antibodies).
- ICGA showed hypofluorescent dots in six patients; intraocular inflammation was managed effectively with corticosteroids and/or immunomodulatory therapy, preserving or improving visual acuity.
Conclusions:
- Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is potentially linked to the development of sarcoid-like uveitis and acute TIN in pediatric patients.
- Prompt diagnosis and multidisciplinary management are crucial for favorable visual outcomes.
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