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Unique clinical spectrum with distinguishing diagnostic features in Vogt-Koyanagi-Harada syndrome
- Source :
- BMJ Case Rep
- Publication Year :
- 2019
- Publisher :
- BMJ, 2019.
-
Abstract
- A 36-year-old ulcerative colitis male patient on treatment for 7 years was referred to dermatology with resistant alopecia universalis and hypopigmented patches on limbs for 5 months. During this time he also reported to ophthalmology with acute bilateral decreased vision for 5 days. His examination revealed hyperaemic discs, multifocal retinal detachments and choroidal granulomas. Taking into account the revised diagnostic criteria, atypical course of disease in the form of early cutaneous presentation followed by ophthalmic manifestations was attributed to Vogt-Koyanagi-Harada syndrome (VKHS) which was supported by relevant investigations including ophthalmic imaging, MRI and nerve conduction studies. Subclinical nerve conduction abnormalities and white matter demyelination were also seen for the first time in a patient of VKHS. Appropriate treatment was required to prevent visual complications; therefore, systemic corticosteroids with steroid sparing immunosuppressive drug therapy showed significant improvement in vision on follow-up. Cutaneous manifestations were resilient to the entire regimen.
- Subjects :
- Adult
Male
medicine.medical_specialty
medicine.medical_treatment
Vision Disorders
Unusual Association of Diseases/Symptoms
Skin Diseases
Diagnosis, Differential
White matter
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Adrenal Cortex Hormones
medicine
Humans
Fluorescein Angiography
Vogt-Koyanagi-Harada syndrome
Subclinical infection
Hypopigmentation
Granuloma
Choroid
business.industry
Retinal Detachment
Alopecia
Retinal
General Medicine
medicine.disease
Magnetic Resonance Imaging
Dermatology
Ulcerative colitis
eye diseases
Regimen
Treatment Outcome
medicine.anatomical_structure
Immunosuppressive drug
chemistry
Alopecia universalis
030221 ophthalmology & optometry
Colitis, Ulcerative
Uveomeningoencephalitic Syndrome
business
Immunosuppressive Agents
Tomography, Optical Coherence
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 1757790X
- Volume :
- 12
- Database :
- OpenAIRE
- Journal :
- BMJ Case Reports
- Accession number :
- edsair.doi.dedup.....590e769027a149b06ca8bb9c28cc1fcd