Reversible alopecia in Vogt-Koyanagi-Harada disease and sympathetic ophthalmia

There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

Abstract

Background

Vogt-Koyanagi-Harada (VKH) disease and sympathetic ophthalmia (SO) are both autoimmune disorders targeting melanin-bearing cells, even though their etiologies are different. Both shared many ocular and systemic manifestations, including integumentary findings. Most of the literature focused on the ocular manifestations and related treatment. Alopecia was seldom mentioned.

Findings

We report one case of VKH disease and one case of SO. Both developed severe alopecia and early sunset glow fundus, which are probably due to incomplete treatment. Fortunately, the alopecia improved soon after systemic steroid treatment.

Conclusions

Early and complete treatments are important in the management of VKH or SO and prevent integumentary manifestation. Alopecia can be reversible after steroid treatment in time.

Related collections

Most cited references 10

Record: found
Abstract: found
Article: found

Is Open Access

Update on Sympathetic Ophthalmia

J. Arevalo, Reinaldo Garcia, Hassan Al-Dhibi … (2012)

Sympathetic ophthalmia (SO) is a bilateral diffuse granulomatous intraocular inflammation that occurs in most cases within days or months after surgery or penetrating trauma to one eye. The incidence of SO ranges from 0.2 to 0.5% after penetrating ocular injuries and 0.01% after intraocular surgery. Vitreoretinal surgery and cyclodestructive procedures are considered risk factors. The time from ocular injury to onset of SO varies greatly, ranging from a few days to decades, with 80% of the cases occurring within 3 months after injury to the exciting eye and 90% within 1 year. The diagnosis is based on clinical findings rather than on serological testing or pathological studies. It presents as a bilateral diffuse uveitis. Patients report an insidious onset of blurry vision, pain, epiphora, and photophobia in the sympathizing, non-injured eye. Classically this is accompanied by conjunctival injection and a granulomatous anterior chamber reaction with mutton-fat keratic precipitates (KPs) on the corneal endothelium. In the posterior segment, the extent of inflammation can vary. Systemic corticosteroids are the first line therapy for SO. If patients are non-responsive to steroid therapy or have clinically significant side effects, cyclosporine, azathioprine or other immunosuppressive agents can be used for long-term immunomodulatory therapy.

0 comments Cited 29 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Evaluation of the effect on outcomes of the route of administration of corticosteroids in acute Vogt-Koyanagi-Harada disease.

Fei Yu, Masahiko Usui, Bahram Bodaghi … (2006)

To compare the effect on outcomes of the route of administration of corticosteroids in acute Vogt-Koyanagi-Harada disease. Retrospective comparative interventional case series. Nine international uveitis specialty clinics. Forty-eight patients presenting over a three-year period to a study center with acute Vogt-Koyanagi-Harada disease. Initial treatment with corticosteroid either orally (Oral only group) or intravenously followed by an oral taper (IV+Oral group). Change in visual acuity with treatment; development of ocular complications, including visually significant cataract, choroidal neovascularization, subretinal fibrosis, fundus pigment migration, nummular hypopigmented lesions, and diffuse fundus depigmentation; use of immunosuppressive therapy. The Oral only group comprised 15 patients (31%) and the IV+Oral group 33 patients (69%). Median follow-up was 15 months. There was no difference in duration of follow-up between groups (P = .234). There was no difference in the change in visual acuity between groups, adjusting for initial visual acuity (P = .402). There were no differences in the rates of development of visually significant cataract, fundus pigmentary changes, or in the rate of use of subsequent immunosuppressive therapy between treatment groups. No patients developed choroidal neovascularization or subretinal fibrosis over the study period. Route of administration of corticosteroid had no detectable effect on change in visual acuity nor on the development of visually significant complications over the study period. Prospective trials are necessary to address speed of resolution and definitively answer outcome questions.

0 comments Cited 26 times – based on 0 reviews      Review now

Bookmark

Record: found
Abstract: found
Article: not found

Mechanisms of inflammatory response in sympathetic ophthalmia and VKH syndrome.

Girish N Rao (1996)

Although the inciting events in the pathogenesis of sympathetic ophthalmia and Vogt-Koyanagi-Harada (VKH) syndrome are different, these two forms of bilateral, granulomatous uveitis share several clinical, histopathological and immunohistochemical features, including their association with HLA types and in their in vitro T-cell response to retinal antigens. These clinical and immunopathological features indicate that there is an underlying T-cell mediated autoimmunity to uveal/retinal antigens in the development of these forms of uveitis. Both forms exhibit preservation of the choriocapillaris and retina despite extensive inflammatory cell infiltration in the choroid. Recent experimental studies suggest that this preservation of choriocapillaris could be the result of anti-inflammatory products secreted by the retinal pigment epithelium, including transforming growth factor-beta and a novel protein called retinal pigment epithelial protective protein that is known to suppress the phagocyte generation of superoxide. Such suppression of the oxidant release in the choroidal inflammation could help protect the uvea from necrotic change and preserve the choriocapillaris from inflammatory cell infiltration.

0 comments Cited 20 times – based on 0 reviews      Review now

Bookmark

All references

Author and article information

Contributors

Chiu-Tung Chuang

Po-Sian Huang

Shih-Chou Chen

Shwu-Jiuan Sheu

Journal

Journal ID (nlm-ta): J Ophthalmic Inflamm Infect

Journal ID (iso-abbrev): J Ophthalmic Inflamm Infect

Title: Journal of Ophthalmic Inflammation and Infection

Publisher: Springer

ISSN (Electronic): 1869-5760

Publication date Collection: 2013

Publication date (Electronic): 15 March 2013

Volume: 3

Page: 41

Affiliations

[1 ]Department of Ophthalmology, Kaohsiung Veterans General Hospital, 386, Ta-Chung 1st Road, Kaohsiung, 813, Taiwan

[2 ]School of Medicine, National Yang-Ming University, Taipei, 112, Taiwan

Article

Publisher ID: 1869-5760-3-41

DOI: 10.1186/1869-5760-3-41

PMC ID: 3620517

PubMed ID: 23514340

SO-VID: 5f5c4424-0f0d-490f-bc6e-243f0543f2a1

License:

This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Reversible alopecia in Vogt-Koyanagi-Harada disease and sympathetic ophthalmia

Read this article at

Abstract

Background

Findings

Conclusions

Related collections

Karger: Ophthalmology

Most cited references 10

Update on Sympathetic Ophthalmia

Evaluation of the effect on outcomes of the route of administration of corticosteroids in acute Vogt-Koyanagi-Harada disease.

Mechanisms of inflammatory response in sympathetic ophthalmia and VKH syndrome.

Author and article information

Contributors

Journal

Affiliations

Article

History

Categories

Comments

Comment on this article

Similar content 973

Cited by 4

Most referenced authors 148