A case study of a US man who lost vision in his right eye for 2 days could provide further insight into how SARS-CoV-2 messes with our immune-system in ways in which cause the body to attack itself.
Like tens of thousands of individuals within the US every day , an unnamed patient aged in his 70s experiencing a runny nose was given a diagnosis of COVID-19. Three weeks later he presented himself to hospital with an entire other batch of symptoms.
In a report detailed by a team of doctors from the Columbia University Vagelos College of Physicians and Surgeons in NY , the person had recovered from the worst of his bout of COVID-19, only to return down with a headache every week later.
This was soon followed by fading vision in his right eye, to point he could only figure out broad motions. Any movement made thereupon eye also induced severe pain.
Cases of impeded vision following a SARS-CoV-2 infection aren’t common, but aren’t unprecedented either, with variety of case reports hinting at potential links. Where this case stands out is within the combination of symptoms, including those intense headaches & discomfort within the eye itself.
A CT scan quickly revealed the source of the patient’s agony were seriously inflamed sinuses extending down the proper side of his face. The case was so serious, it had been causing the bone itself to erode, necessitating an procedure to get rid of the maximum amount of the inflamed material as possible from each of the cavities.
The surgery appeared to be a winning strategy, at first. But soon the pain returned and his vision once more worsened.
Tissue cultures showed the presence of a bacterium called Streptococcus constellatus. Typically at-home within the intestines & oral cavity , this happy human bug can turn particularly nasty when relocated to other areas of the body.
Still, the antibiotics should are putting a lid on this particular microbe’s appetite for destruction.
Further investigation revealed a prevalence of active type of white blood cell on prowl, one that typically churns out a wierd little antibody called IgG4. faraway from your typical antibody, it’s capable of reassembling itself in clever ways in which turn them into asymmetrical patchworks.
It’s also got a reputation for causing its own litany of problems through IgG4-related disease (RD) – an autoimmune condition which might strike almost any a part of the body, whipping up inflammation & causing all manner of pain & misery within the form of highly fibrotic lesions.
With a diagnosis of IgG4-related rhinosinusitis, the patient was given a course of steroids and was soon back on path to healthiness & clear vision. Three weeks later he was completely recovered.
While it’d make a half-decent episode of House, the invention also leaves us with intresting question. Could the patient’s infection with SARS-CoV-2 have played a role? Or was it just a series of unrelated, if unfortunate events?
There is a possible link. While the explanation for IgG4-RD isn’t known, there are often suspiciously large numbers of another type of white cell hanging about IgG4-RD lesions, called cytotoxic CD4-positive T-cell.
If this were a criminal offense show, there’d be a scene now where a SARS-CoV-2-sensitive CD4+ T-cell was dragged into the interrogation room & badgered over why it had been also found hanging around inside patients hospitalized with COVID-19.
We know SARS-CoV-2 may be a mastermind when it involves messing with our immune reaction . It’s no great leap to feature another crime against immunity to its rap sheet.
Yet even taking under consideration an earlier medical case study hinting at an equivalent potential link between IgG4-RD & COVID-19, it’s just too soon to draw any solid conclusions between the 2 diseases.
So far into this global pandemic, with numerous cases at hand, it are often hard to inform rare coincidences aside from meaningful connections.
This research was published in JAMA Otolaryngology-Head & Neck Surgery.