Sarcoidosis presenting as bilateral optic neuritis after ChAdOx1 nCoV-19 vaccination

Submitted: March 29, 2022
Accepted: May 16, 2022
Published: June 8, 2022
Abstract Views: 1068
PDF: 281
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.


Sarcoidosis is an idiopathic granulomatous disease and can virtually affect any organ system. Multiple factors, including tubercular antigens organic and environmental exposures, have been implicated in its pathogenesis. In addition to drugs, sarcoid-like reactions have been reported following varicella and influenza vaccination. Few reports of erythema nodosum and Lofgren syndrome have been reported after the COVID19 vaccination, though no histologic diagnosis was pursued in these cases. We herein report a case of sarcoidosis presenting with bilateral acute onset vision loss with a temporal association with COVID19 vaccination (ChadOx-1 n-COV, COVISHIELDTM). Symptoms started within two weeks of receiving the vaccine. Alternate causes for optic neuritis were excluded. Transbronchial lung biopsy showed the presence of non-caseating epithelioid cell granulomas. The patient received high-dose corticosteroids immediately after diagnosis, albeit with incomplete clinical improvement in vision on a three-month follow-up. In conclusion, we report a novel case of sarcoidosis-related optic neuritis following COVID19 vaccination. 



PlumX Metrics


Download data is not yet available.


Zissel G, Müller-Quernheim J. Sarcoidosis: historical perspective and immunopathogenesis (Part I). Respir Med 1998;92:126–39. DOI:
Madan K, Sryma PB, Pattnaik B, et al. Clinical profile of 327 patients with sarcoidosis in India: An ambispective cohort study in a tuberculosis (TB) endemic population. Lung India 2022;39:51–7. DOI:
Ungprasert P, Tooley AA, Crowson CS, et al. Clinical characteristics of ocular sarcoidosis: A population-based study 1976–2013. Ocul Immunol Inflamm 2019;27:389–95. DOI:
Rothova A. Ocular involvement in sarcoidosis. Br J Ophthalmol 2000;84:110–6. DOI:
Kidd DP, Burton BJ, Graham EM, Plant GT. Optic neuropathy associated with systemic sarcoidosis. Neurol Neuroimmunol Neuroinflammation 2016;3:e270. DOI:
Puri S, Hernandez-Peraza Z, Sweiss N, Macintosh P. Clinical features of isolated optic neuritis due to sarcoidosis: an institutional experience. Neurology 2020;94:2034.
Wingerchuk DM, Banwell B, Bennett JL, et al. International consensus diagnostic criteria for neuromyelitis optica spectrum disorders. Neurology 2015;85:177–89. DOI:
Groen F, Rothova A. Ocular involvement in sarcoidosis. Semin Respir Crit Care Med 2017;38:514–22. DOI:
Desbois A-C, Marques C, Lefèvre L, et al. Prevalence and clinical features of COVID-19 in a large cohort of 199 patients with sarcoidosis. Clin Exp Rheumatol 2022;40:195–6. DOI:
George LJ, Philip AM, John KJ, et al. A review of the presentation and outcome of sarcoidosis in coronavirus disease 2019. J Clin Transl Res 2021;7:657–65.
Gracia-Ramos AE, Martin-Nares E, Hernández-Molina G. New onset of autoimmune diseases following COVID-19 diagnosis. Cells 2021;10:3592. DOI:
Capaccione KM, McGroder C, Garcia CK, et al. COVID-19-induced pulmonary sarcoid: A case report and review of the literature. Clin Imaging 2022;83:152–8. DOI:
Manansala M, Chopra A, Baughman RP, et al. COVID-19 and sarcoidosis, readiness for vaccination: Challenges and opportunities. Front Med (Lausanne) 2021;8:672028. DOI:
Haseeb AA, Solyman O, Abushanab MM, et al. Ocular complications following vaccination for COVID-19: A one-year retrospective. Vaccines 2022;10:342. DOI:
Hsu H-T, Su H-A, Chen Y-C. Erythema nodosum, after Medigen vaccination against COVID-19? J Formos Med Assoc Taiwan Yi Zhi 2022;121:723–4. DOI:
Aly MH, Alshehri AA, Mohammed A, et al. First case of erythema nodosum associated with Pfizer vaccine. Cureus 2021;13:e19529. DOI:
Teymour S, Ahram A, Blackwell T, et al. Erythema nodosum after Moderna mRNA-1273 COVID-19 vaccine. Dermatol Ther 2022;35:e15302. DOI:
Rademacher J-G, Tampe B, Korsten P. First report of two cases of Löfgren’s syndrome after SARS-CoV-2 vaccination-Coincidence or causality? Vaccines 2021;9:1313. DOI:
Wu X, Lim JHL, Lee JSS, Chio MT-W. Recurrent erythema nodosum after the second dose of the Pfizer-BioNTech BNT162b2 COVID-19 messenger RNA vaccine. JAAD Int 2022;6:107–8. DOI:
Leber HM, Sant’Ana L, Konichi da Silva NR, et al. Acute thyroiditis and bilateral optic neuritis following SARS-CoV-2 vaccination with CoronaVac: A case report. Ocul Immunol Inflamm 2021;29:1200–6. DOI:

How to Cite

Shukla, Amarendra Kumar, Amrutha Peter, Jitendra Kishore Bhargava, Veerendra Arya, Manish Kumar Gupta, Nishtha Yadav, and Pawan Tiwari. 2022. “Sarcoidosis Presenting As Bilateral Optic Neuritis After ChAdOx1 NCoV-19 Vaccination”. Monaldi Archives for Chest Disease 93 (1).