Vogt-Koyanagi-Harada disease in an 8-year-old boy
10.5415/apallergy.2011.1.2.98
- Author:
Budi SETIABUDIAWAN
1
;
Feti KARFIATI
;
Reni GHRAHANI
;
Gartika SAPARTINI
;
Indra SAHRIL
Author Information
1. Department of Child Health, Medical School, Padjadjaran University, Dr. Hasan Sadikin Hospital, Bandung, Indonesia. setiabudiawan@yahoo.com
- Publication Type:Case Report
- Keywords:
Vogt-Koyanagi-Harada;
Melanocyte;
Visual disturbance;
Methylprednisolone
- MeSH:
Americas;
Anterior Chamber;
Asia;
Atrophy;
Autoimmune Diseases;
Central Nervous System;
Child;
Continental Population Groups;
Endothelium;
Eyebrows;
Eyelashes;
Eyelids;
Female;
Follow-Up Studies;
Forehead;
Hair;
Hearing;
Humans;
Immunoglobulin G;
Lymphocytes;
Male;
Melanocytes;
Methylprednisolone;
Monophenol Monooxygenase;
Nose;
Otitis;
Panuveitis;
Parents;
Paresis;
Pupil;
Rubella;
Skin;
Uveomeningoencephalitic Syndrome;
Visual Acuity;
Vitiligo
- From:
Asia Pacific Allergy
2011;1(2):98-103
- CountryRepublic of Korea
- Language:English
-
Abstract:
Vogt-Koyanagi-Harada (VKH) disease is an autoimmune disease involving pigmented tissue in eyes, auditory system, skin, and central nervous system. The pathogenesis is a result of T cell lymphocyte reaction against melanocyte component, tyrosinase and tyrosinase-related protein. This disease uniquely affected pigmented race in Asia and native America, mostly women aged 20-50. We reported an 8-years-old boy complained for visual disturbance since 6 weeks prior admission. Two years earlier, the parents noted the patient eyes were looked red when photographed (suggesting a dilated pupil) preceded by whitened on the right forehead and nose and whitened hair, eyebrow and eyelashes. The examination showed a vitiligo and skin atrophy on right frontal and right nasal, poliosis on the eyebrows, eyelids and hair. The diameter of right pupil was 8 mm, with a paresis on 3rd, 4th, 6th, and 9th nerves. Fundus examination revealed sunset glow appearance. The visual acuity on the right eye: 2/60, left eye: 1-0. There's positive serology for antitoxoplasma IgG, anti Rubella IgG, anti CMV IgG. The patient was diagnosed with a VKH disease and then prescribed with methylprednisolone 1 mg/kg/day. The patient also had further follow up with dermatovenerologist and ophthalmologist. The eye examination revealed an improvement on right eye panuveitis, with a remaining keratic precipitate in the endothelium, and minimal flare and cell on the anterior chamber. ENT consultation revealed no ear inflammation or hearing disturbance.
