Acute Vision Loss From IgG4-Related and Bacterial Rhinosinusitis After COVID-19

Harb, Amro A; Chen, Yanglu; Ben-Ami, Johanna; Francke, Michael; Hur, Chin; Turk, Andrew T.; Gudis, David A.

doi:10.1001/jamaoto.2021.2121

Cited by 3 publications

(3 citation statements)

References 7 publications

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“…This article reports a rare case of IgG4‐associated disease following COVID‐19 and a literature review of previous related case reports (Table 1). We found a total of six cases of IgG4 disease relevant to COVID‐19, three of which were new‐onset IgG4‐associated diseases following COVID‐19 vaccination and the remaining three following SARS‐CoV‐2 infection 2–7 . IgG4 disease does not target a specific organ and can present as pancreatitis, hepatitis, lymph node enlargement, or even tracheal injury.…”

Section: Discussionmentioning

confidence: 99%

A rare case of IgG4‐associated disease caused by COVID‐19: Case report and literature review

Zheng

Qiu

2023

Int J of Rheum Dis

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An increasing number of cases have reported that coronavirus disease 2019 (COVID‐19) can lead to immune system dysregulation and induce autoimmune diseases, but the mechanism is unclear. We treated a patient who presented with an unknown fever after infection with the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) in 2023. After excluding the possibility of infection, malignancy, and other connective tissue diseases, we considered the diagnosis of IgG4‐related disease in consideration of the patient's pathology and clinical findings. In this article, we summarize our diagnostic experience and summarize the case reports of IgG4‐related diseases associated with SARS‐CoV‐2 infections since the COVID‐19 pandemic.

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Section: Discussionmentioning

confidence: 99%

A rare case of IgG4‐associated disease caused by COVID‐19: Case report and literature review

Zheng

Qiu

2023

Int J of Rheum Dis

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“…We conducted a literature review of previously reported cases of IgG4-RD following SARS-CoV-2 infection or vaccination (Table 1) (17)(18)(19)(20)(21)(22)(23)(24)(25). We retrieved a total of 9 cases, of which 5 developed symptoms after vaccination and 4 after infection.…”

Section: Discussionmentioning

confidence: 99%

A case of IgG4-related ophthalmic disease after SARS-CoV-2 vaccination: case report and literature review

Zhang,

Wu,

et al. 2024

Front. Immunol.

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Coronavirus disease 19 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is affecting the world with a surge in cases. A variety of autoimmune diseases occur after SARS-CoV-2 infection or vaccination, of which IgG4-related disease (IgG4-RD) is an important type. IgG4-RD can involve multiple organs of the body. The ocular manifestation of IgG4-RD is called IgG4-related ophthalmic disease (IgG4-ROD). We herein report a patient diagnosed with IgG4-ROD. The patient developed ptosis and vision loss after SARS-CoV-2 vaccination, and the symptoms worsened after SARS-CoV-2 infection. After excluding other diseases like myasthenia gravis and Eaton-Lambert syndrome that may cause ptosis, the diagnosis of IgG4-ROD was confirmed by pathological examination. We discussed the predisposing factors, diagnosis and treatment of this patient to provide a more empirical and theoretical basis for clinical diagnosis and treatment. We conducted a literature review of previously reported cases of IgG4-RD following SARS-CoV-2 infection or vaccination. We retrieved a total of 9 cases, of which 5 developed symptoms after vaccination and 4 after infection. Demographic and clinical characteristics were summarized. In conclusion, our case represents the first case of proven IgG4-ROD after COVID-19 vaccination. We believe that IgG4-ROD and SARS-CoV-2 infection or vaccination are closely related, and the immune system disorder caused by SARS-CoV-2 infection or vaccination may be a key factor in the pathogenesis of IgG4-RD. But for now, there is no direct evidence that there is a causal relationship between SARS-CoV-2 infection or vaccination and IgG4-ROD, which still needs more research and exploration to confirm.

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“…A recent case report by Harb. A. et al [ 49 ] described a patient suffering acute vision loss from IgG4-related and bacterial rhinosinusitis after a COVID-19 infection, improving on corticosteroid and antibiotic treatment. This pathway being one of the prominent activated pathways in the IgG4-ROD group supports the hypothesis of microorganisms being a conductor in the activation of inflammation leading to a chronic disease that exacerbates in IgG4-immunopositive plasma cell infiltration [ 50 ].…”

Section: Discussionmentioning

confidence: 99%

Novel Insights into Pathophysiology of Orbital Inflammatory Diseases and Progression to Orbital Lymphoma by Pathway Enrichment Analysis

Al-Ghazzawi

Mairinger

Pförtner

et al. 2022

Life

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Non-specific orbital inflammation (NSOI) and IgG4-related orbital disease (IgG4-ROD) are currently treated with non-specific immunosuppressive agents based on non-randomized, uncontrolled studies. Therefore, relapses and prolongated courses are common and remain challenging. For a more specific therapy, a better understanding of the underlying pathophysiology is crucial. Therefore, we aimed to analyze signaling pathways to expand the knowledge on the pathophysiology and possibly identify specific targets in the future, as occurred recently in Graves’ orbitopathy with the IGF-1 receptor. Furthermore, we analyzed potential mechanisms for the described potential progression to orbital MALT (mucosa-associated lymphoid tissue) lymphoma. The investigation cohort for this screening study comprised of 12 patients with either typical NSOI (n = 6), IgG4-ROD or MALT lymphoma (n = 3 each). Mean age was 56.4 ± 17 years. MALT samples, in contrast with IgG4-ROD and NSOI, showed overall upregulation for extracellular matrix receptor interaction (ECM) and adipocytokine signaling. Investigating signaling compounds for MALT samples, differentially expressed genes were re-identified as targets with relevant expression. Even though pathway analysis showed differentially altered products when comparing IgG4-ROD with MALT, main conductors of differentiation in B- and T-cell signaling were commonly altered when observing the microenvironment of examined tissues. Our data reveal the characteristic differences and similarities in genetic-expression-based pathway profiles between MALT lymphoma, IgG4-ROD and NSOI, which may be useful for elucidating the associated pathogenic mechanisms and developing specific treatments for these orbital diseases.

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Acute Vision Loss From IgG4-Related and Bacterial Rhinosinusitis After COVID-19

Cited by 3 publications

References 7 publications

A rare case of IgG4‐associated disease caused by COVID‐19: Case report and literature review

A rare case of IgG4‐associated disease caused by COVID‐19: Case report and literature review

A case of IgG4-related ophthalmic disease after SARS-CoV-2 vaccination: case report and literature review

Novel Insights into Pathophysiology of Orbital Inflammatory Diseases and Progression to Orbital Lymphoma by Pathway Enrichment Analysis

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