Vogt–Koyanagi–Harada syndrome: a rheumatologic perspective
نویسندگان
چکیده
The increasingly close collaboration between ophthalmologists and rheumatologists is greatly aiding the early diagnosis and more effective interdisciplinary management of patients with inf lammatory eye involvement associated with many multisystem diseases [1–3]. For example, occurrence of acute anterior uveitis in patients with ankylosing spondylitis and related spondylo arthropathies is more painful and frightening for these patients than their back pain and stiffness, so that most of them will urgently seek ophthalmology consultation. Ophthalmologists are increasingly referring to rheumatologists those patients with acute anterior uveitis who have rheumatological complaints, especially the subset that possesses HLA-B27 [1,2]. Furthermore, they are also referring patients with many other forms of noninfectious chronic ocular inflammation that require immunomodulatory therapy (IMT) owing to increasing reliance on rheumatologists for the management of such therapy [3]. Vogt–Koyanagi–Harada (VKH) syndrome is one such disease that requires IMT for its optimal management, and failure to do so portends a poor prognosis [4,5]. It is therefore necessary for the rheumatologists to be familiar with its clinical aspects, pathogenesis and appropriate management. Vogt–Koyanagi–Harada syndrome is an idiopathic systemic inflammatory disease that was reported in the early 20th Century [6], although it was first described in the 10th Century by the famous Arab scientist and ophthalmologist Ali ibn Isa in his landmark textbook on ophthalmology, Notebook of the Oculists [7], and later by another Arab physician, Mohammad Al-Ghafiqi, in the 12th Century [6]. It is an autoimmune disorder of melanocyte proteins that occurs in genetically susceptible individuals and affects various melanocyte-containing structures, including the eyes, meninges, inner ear and skin [5,8,9]. It classically leads to bilateral chronic granulomatous diffuse uveitis, sensorineural hearing loss, meningitis and cutaneous findings of vitiligo, poliosis (loss of hair pigment) and alopecia [4,5,10,11].
منابع مشابه
Applicability of the 2001 revised diagnostic criteria in Brazilian Vogt-Koyanagi-Harada disease patients.
PURPOSE To determine the applicability of the international revised diagnostic criteria for Vogt-Koyanagi-Harada disease. METHODS Retrospective study. Medical charts of 140 patients with the diagnosis of Vogt-Koyanagi-Harada disease, from the Uveitis Sector of the Federal University of Sao Paulo (UNIFESP), were revised and classified following the revised diagnostic criteria. RESULTS Of the...
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Vogt-Koyanagi-Harada syndrome is an acquired illness with ocular, cutaneous, and/or neurologic features. A 4-year-old child who acutely developed visual disturbances and headache and was found to have serous retinal detachments and aseptic meningitis is presented. Improvement was rapid with corticosteroid therapy. This is the youngest reported patient with Vogt-Koyanagi-Harada syndrome.
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We describe herein 2 patients who developed Vogt-Koyanagi-Harada syndrome in the course of renal biopsy-proven immunoglobulin A (IgA) nephropathy. A 61-year-old man with an 11-year history of IgA nephropathy and a 16-year history of thyroiditis, and a 56-year-old man with a 5-year history of IgA nephropathy developed Vogt-Koyanagi-Harada syndrome. At the time of the eye disease presentation, Ig...
متن کاملVogt-Koyanagi-Harada disease.
Vogt-Koyanagi-Harada (VKH) disease, also known as uveomeningitic syndrome, is an idiopathic multisystem inflammatory disease with bilateral uveitis. Patients with bilateral anterior uveitis with vitiligo, poliosis, alopecia, and dysacousia were first described by Vogt in 1906 and then Koyanagi in 1929. Harada described a case of posterior uveitis with exudative retinal detachment and pleocytosi...
متن کاملNew insights into Vogt-Koyanagi-Harada disease.
Vogt-Koyanagi-Harada disease (VKH), a well-established multiorgan disorder affecting pigmented structures, is an autoimmune disorder of melanocyte proteins in genetically susceptible individuals. Several clinical and experimental data point to the importance of the effector role of CD4+ T cells and Th1 cytokines, the relevance of searching a target protein in the melanocyte, and the relevance o...
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