{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:05:19Z","timestamp":1753891519243,"version":"3.41.2"},"reference-count":13,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,6,20]],"date-time":"2023-06-20T00:00:00Z","timestamp":1687219200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:p>Hematopoietic stem cell transplantation (HSCT) recipients affected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have a high mortality rate. The American Society of Transplantation and Cellular Therapy (ASTCT) and the European Society for Blood and Marrow Transplantation (EBMT) recommend vaccination for these vulnerable populations. However, emerging data suggested that vaccination might elicit immunological adverse events, including an exacerbation of graft-vs.-host disease (GVHD). Herein, we report a case of severe optic neuritis developed shortly after AstraZeneca COVID-19 vaccination in an allogeneic HSCT recipient with underlying chronic GVHD. The patient had a headache 5 days after vaccination, and the disease progressed rapidly to complete blindness 17 days after the vaccination. The diagnosis of optic neuritis was well-confirmed by the presence of an anti-myelin oligodendrocyte glycoprotein antibody and the typical features of MRI image and Ophthalmoscopy. Other differential diagnoses, such as infection or leukemia relapse in the central nervous system (CNS), were carefully excluded. A timely high-dose corticosteroid was administered, and her visual acuity improved rapidly. She returned to her baseline status 1 month later. With more than 1 year of follow-up, no optic neuritis or leukemia relapse was observed. In summary, allogeneic transplant recipients can develop severe optic neuritis after vaccination. Optic neuritis can be an exacerbation of GVHD or rarely a sporadic adverse event of vaccination. Furthermore, our experience indicates that a prompt diagnosis and early steroid treatment are vital for a good recovery.<\/jats:p>","DOI":"10.3389\/fmed.2023.1177610","type":"journal-article","created":{"date-parts":[[2023,6,20]],"date-time":"2023-06-20T07:42:28Z","timestamp":1687246948000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Case report: Sudden onset optic neuritis shortly after SARS-CoV-2 vaccination in an allogeneic hematopoietic stem cell transplant recipient with chronic graft-vs.-host disease"],"prefix":"10.3389","volume":"10","author":[{"given":"Chiang","family":"Chu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shin-Kuang","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi-Ching","family":"Shao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Su-Peng","family":"Yeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,6,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1416","DOI":"10.1080\/13685538.2020.1774748","article-title":"Risk factors for mortality in patients with Coronavirus disease 2019 (COVID-19) infection: a systematic review and meta-analysis of observational studies","volume":"23","author":"Parohan","year":"2020","journal-title":"Aging Male."},{"key":"B2","doi-asserted-by":"publisher","first-page":"e185","DOI":"10.1016\/S2352-3026(20)30429-4","article-title":"Clinical characteristics and outcomes of COVID-19 in haematopoietic stem-cell transplantation recipients: an observational cohort study","volume":"8","author":"Sharma","year":"2021","journal-title":"Lancet Haematol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"938","DOI":"10.1016\/j.jtct.2021.07.008","article-title":"Safety and tolerability of SARS-CoV2 emergency-use authorized vaccines for allogeneic hematopoietic stem cell transplant recipients","volume":"27","author":"Ali","year":"2021","journal-title":"Transplant Cell Ther"},{"key":"B4","doi-asserted-by":"publisher","first-page":"788","DOI":"10.1016\/j.jtct.2021.06.024","article-title":"Safety and immunogenicity of the BNT162b2 mRNA COVID-19 vaccine in patients after allogeneic HCT or CD19-based CART therapy-a single center prospective cohort study","volume":"27","author":"Ram","year":"2021","journal-title":"Transplant Cell Ther."},{"key":"B5","doi-asserted-by":"publisher","first-page":"103705","DOI":"10.1016\/j.ebiom.2021.103705","article-title":"Safety and efficacy of the mRNA BNT162b2 vaccine against SARS-CoV-2 in five groups of immunocompromised patients and healthy controls in a prospective open-label clinical trial","volume":"74","author":"Bergman","year":"2021","journal-title":"EBioMedicine."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1125","DOI":"10.1038\/bmt.2015.84","article-title":"Late post-transplant anti-aquaporin-4 Ab-positive optic neuritis in a patient with AML","volume":"50","author":"Diamanti","year":"2015","journal-title":"Bone Marrow Transplant."},{"key":"B7","doi-asserted-by":"publisher","first-page":"224","DOI":"10.3109\/01658107.2014.907321","article-title":"Bilateral inflammatory optic neuropathy related to graft versus host disease following allogeneic bone marrow transplantation for Hodgkin disease","volume":"38","author":"Moesen","year":"2014","journal-title":"Neuroophthalmology."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1453","DOI":"10.2169\/internalmedicine.48.2003","article-title":"Encephalomyelitis mimicking multiple sclerosis associated with chronic graft-versus-host disease after allogeneic bone marrow transplantation","volume":"48","author":"Matsuo","year":"2009","journal-title":"Int Med."},{"key":"B9","doi-asserted-by":"publisher","first-page":"2619","DOI":"10.1182\/blood.V91.7.2619.2619_2619_2620","article-title":"Immune-mediated optic neuritis after unrelated allogeneic bone marrow transplantation","volume":"91","author":"Ooi","year":"1998","journal-title":"Blood."},{"key":"B10","doi-asserted-by":"publisher","first-page":"502","DOI":"10.1038\/s41409-021-01543-z","article-title":"Chronic graft-versus-host disease exacerbation after SARS-CoV-2 vaccination","volume":"57","author":"Trunk","year":"2022","journal-title":"Bone Marrow Transplant."},{"key":"B11","doi-asserted-by":"publisher","first-page":"330","DOI":"10.3390\/vaccines10020330","article-title":"Humoral responses and chronic GVHD exacerbation after COVID-19 vaccination post allogeneic stem cell transplantation","volume":"10","author":"Pabst","year":"2022","journal-title":"Vaccines."},{"key":"B12","doi-asserted-by":"publisher","first-page":"5198","DOI":"10.1007\/s00415-022-11194-9","article-title":"MOG encephalomyelitis after vaccination against severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2): case report and comprehensive review of the literature","volume":"269","author":"Jarius","year":"2022","journal-title":"J Neurol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1097\/ICU.0000000000000197","article-title":"Should patients with optic neuritis be treated with steroids?","volume":"26","author":"Mackay","year":"2015","journal-title":"Curr Opin Ophthalmol."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1177610\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,6,20]],"date-time":"2023-06-20T07:42:33Z","timestamp":1687246953000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1177610\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,6,20]]},"references-count":13,"alternative-id":["10.3389\/fmed.2023.1177610"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2023.1177610","relation":{},"ISSN":["2296-858X"],"issn-type":[{"type":"electronic","value":"2296-858X"}],"subject":[],"published":{"date-parts":[[2023,6,20]]},"article-number":"1177610"}}