Vogt-Koyanagi-Harada (VKH) disease is a primary stromal choroiditis with bilateral granulomatous panuveitis. If initial-onset VKH is treated early and relentlessly the disease can be controlled and even “cured” in a substantial number of cases. We are reporting on a patient treated early and in a sustained fashion who was inflammation free for seven years but who presented a reactivation 6 weeks after the second dose of anti-SARS-CoV-2 vaccination. A 43-year-old woman presented with severe initial-onset VKH disease which was brought under control using steroidal and non-steroidal Immunosuppression (mycophenolic acid and cyclosporine) with additional infliximab infusions because of the persistence of subclinical choroiditis identified on ICGA. Under infliximab alone disease had been inflammation free with no subclinical disease and absence of sunset glow fundus for 6 years. However, following anti-SARS-CoV-2 vaccination, severe resurgence of the disease occurred with exudative retinal detachments. Disease was rapidly brought again under control with oral prednisone (1 mg/kg) therapy and a new loading scheme of infliximab therapy. VKH disease results from an autoimmune process directed against melanocyte associated antigens which can be controlled when early and sustained immunosuppressive treatment is introduced. It seems that anti-SARS-CoV-2 vaccination can be at the origin of reactivation of long-time controlled disease.

中文翻译：

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接种抗 SARS-CoV-2 疫苗后，Vogt-小柳-原田病重新激活已得到控制超过 6 年

Vogt-Koyanagi-Harada (VKH) 病是一种原发性间质脉络膜炎，伴有双侧肉芽肿性全葡萄膜炎。如果初发的 VKH 得到早期和不懈的治疗，在相当多的病例中，该疾病可以得到控制，甚至“治愈”。我们报告了一位接受早期持续治疗的患者，该患者七年没有炎症，但在第二剂抗 SARS-CoV-2 疫苗接种后 6 周出现重新激活。一名 43 岁女性患有严重的初发 VKH 病，由于 ICGA 发现亚临床脉络膜炎持续存在，使用类固醇和非类固醇免疫抑制剂（麦考酚酸和环孢素）并额外输注英夫利昔单抗使该病得到控制。在单独使用英夫利昔单抗的情况下，该病已无炎症，无亚临床疾病，并且六年内没有出现晚霞眼底。然而，在接种抗 SARS-CoV-2 疫苗后，疾病严重复发，并出现渗出性视网膜脱离。通过口服泼尼松（1 mg/kg）治疗和新的英夫利昔单抗治疗方案，疾病迅速得到控制。VKH 疾病是由针对黑素细胞相关抗原的自身免疫过程引起的，当引入早期和持续的免疫抑制治疗时，该过程可以得到控制。抗 SARS-CoV-2 疫苗接种似乎可能是长期受控疾病重新激活的根源。