Post-COVID-19 vaccine medium-vessel vasculitis and acute anterior uveitis, causation vs temporal relation; case report and literature review

INTRODUCTION: and importance: Multiple immunologic phenomena were reported following the administration of COVID-19 vaccines. However, the important point is that their possible association with medium-vessel vasculitis involving the celiac trunk and its branches with acute anterior uveitis in the same patient has not been reported before. CASE PRESENTATION: In this manuscript, we are reporting a case of a middle-aged gentleman who developed vasculitis involving the celiac trunk and its branches, and acute anterior uveitis one week and three weeks after the second dose of Pfizer BioNTech COVID-19 vaccine, respectively. The patient showed significant clinical and radiographic improvement after receiving corticosteroids and azathioprine. CLINICAL DISCUSSION: Previously reported cases of vasculitis following COVID-19 vaccines included both renal-limited and more generalized vasculitis with some being positive and others negative for ANCA (anti-neutrophil cytoplasmic antibodies). Nevertheless, it is worth mentioning that most cases responded to immunosuppressive treatment. Post-COVID-19 vaccine uveitis was reported in patients with different age spans including both anterior and posterior uveitis, with remission being achieved after the use of corticosteroids. CONCLUSIONS: Multiple cases of vasculitis and acute anterior uveitis were reported following COVID-19 vaccines; however, it is important to mention that more research is needed to establish an association between the COVID-19 vaccine and both vasculitis and acute anterior uveitis. In our opinion, the benefits of the COIVID-19 vaccine largely outweigh the expected risks.