Author:

Keywords:

Science & Technology, Life Sciences & Biomedicine, Medicine, General & Internal, General & Internal Medicine, 1101 Medical Biochemistry and Metabolomics, 3202 Clinical sciences

Abstract:

Purpose: To evaluate the clinical presentation of Vogt-Koyanagi-Harada syndrome in Belgian patients in comparison with the literature. Methods: A retrospective case series of 12 patients diagnosed and treated in a university hospital. The 12 patient files were checked for gender, age, ethnicity, duration of follow-up, stage of disease, ocular and extraocular manifestations, presence of symptomatic lymphocytic meningitis, differential diagnosis, treatment and side effects, number of recurrences, complications and time to complete remission. Results: Besides ocular manifestations all 12 patients had also neurological manifestations with headache (100%) and lymphocytic meningitis (75%) as main findings. The primary auditory (67%) and dermatological (33%) manifestations were respectively tinnitus (50%) and vitiligo (33%). Recurrent uveitis occurred in the majority (64%) with an average of 2.1 times per patient and a mean time to recurrence of 5.7 months. An ophthalmologic complete remission was achieved in 7 (58%) patients after a mean period of 14 months (ranging from 2 to 42 months). There is a favourable prognosis with normal visual acuity in 92% of patients at the end of the follow-up. Conclusion: Vogt-Koyanagi-Harada syndrome is a rare disorder that is little known in general medicine. The main problem is that this disorder affects multiple systems and patients are not always seen first by an ophthalmologist. That’s why every internist should keep this syndrome in mind when examining a patient with visual complaints associated with general symptoms such as headache, general malaise, fever and nausea. Those general symptoms may not simply be attributed to the uveitis, but their presence should be an argument to do a lumbar puncture to rule out underlying lymphocytic meningitis. Contrariwise there has to be an ophthalmologic examination in each patient with unexplained general symptoms to rule out Vogt-Koyanagi-Harada syndrome.