COVID-19 vaccination, dengue hepatitis, and recurrent unilateral anterior uveitis
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Date
2023-05
Journal Title
Journal ISSN
Volume Title
Publisher
All India Ophthalmological Society
Abstract
A 36-year-old Asian Indian male presented with redness and pain in his right eye of 1 week duration. He was diagnosed to have right acute anterior uveitis and had a history of being admitted at a local hospital for dengue hepatitis a month earlier. He had been on adalimumab 40 mg three weekly once and oral methotrexate 20 mg/week for human leucocyte antigen (HLA) B27 spondyloarthropathy and recurrent anterior uveitis. Our patient had re-activation of his anterior chamber inflammation on three distinct occasions: first, 3 weeks following recovery from coronavirus disease 2019 (COVID-19), the second after the second dose of COVID-19 vaccination, and the third after recovery from dengue fever-associated hepatitis. We propose molecular mimicry and bystander activation as the postulated mechanisms for the re-activation of his anterior uveitis. In conclusion, patients with auto-immune diseases can have recurrent ocular inflammation following COVID-19 or its vaccination or dengue fever as seen in our patient. The anterior uveitis is usually mild and responds to topical steroids. Additional immuno-suppression may not be needed. Mild ocular inflammation following vaccination should not deter individuals from getting COVID-19 vaccination.
Description
Keywords
Adalimumab, COVID?19 vaccination, dengue hepatitis, methotrexate, recurrent anterior uveitis
Citation
Sanjay Srinivasan, Kawali Ankush, Mahendradas Padmamalini. COVID-19 vaccination, dengue hepatitis, and recurrent unilateral anterior uveitis. Indian Journal of Ophthalmology. 2023 May; 71(5): 2269-2272