Dacryoadenitis is an inflammation of the lacrimal gland that primarily affects children and young adults. It is characterized by pain, redness, and swelling of the upper eyelid. The condition can be unilateral and is often accompanied by fever and preauricular lymphadenopathy. Various causes can lead to dacryoadenitis, including infectious (viral and bacterial) and non-infectious inflammatory etiologies.
Recent research suggests that SARS-CoV-2, the virus responsible for COVID-19, may have implications for dacryoadenitis. Studies have shown an increased risk of developing autoimmune diseases in individuals infected with SARS-CoV-2. In a retrospective case-control study, researchers found immunoreactivity for SARS-CoV-2 nucleocapsid protein and strong expression of angiotensin converting enzyme-2 (ACE2) in the lacrimal gland of a patient with both idiopathic dacryoadenitis and SARS-CoV-2 infection.
Cases of idiopathic dacryoadenitis have also been associated with recent SARS-CoV-2 infection and COVID-19 vaccination. One reported case involved a 14-year-old boy who developed unilateral dacryoadenitis shortly after receiving a COVID-19 vaccine. The exact relationship between SARS-CoV-2 infection, vaccination, and the development of dacryoadenitis is still unknown and requires further investigation.
To diagnose dacryoadenitis, a thorough ophthalmic examination is necessary, along with imaging studies such as CT or MRI. Laboratory evaluations, including blood tests and antigen/antibody testing for SARS-CoV-2, can provide valuable information. In cases where systemic involvement or resistance to treatment is present, a biopsy of the lacrimal gland may be required to identify the underlying cause.
Treatment for dacryoadenitis depends on the suspected etiology. Empirical antibiotic therapy is recommended when the cause is unclear. Viral etiologies generally require supportive care, while non-infectious inflammatory cases often respond well to oral corticosteroids. In some instances, radiation therapy or systemic immunomodulating therapy may be necessary.
In conclusion, the implications of SARS-CoV-2 infection on dacryoadenitis are still being explored. The virus has been associated with an increased risk of developing autoimmune diseases, including idiopathic dacryoadenitis. Further research is needed to determine the exact relationship between SARS-CoV-2 and the development of dacryoadenitis, as well as the impact of COVID-19 vaccination on the condition.
Sources:
– “Review of Dacryoadenitis” – EyeRounds.org
– Kase et al. (2021), Hong Kong. “Increased Risk of Autoimmune Disease After SARS-CoV-2 Infection” – JAMA Network Open
– Murphy et al. (2021), United Kingdom. “Dacryoadenitis Following COVID-19 Vaccination” – BMJ Case Reports
