In:
Practical Neurology, BMJ, Vol. 19, No. 4 ( 2019-08), p. 364-367
Abstract:
Vogt-Koyanagi-Harada disease is a rare, multisystem, autoimmune disorder with numerous clinical manifestations, mediated through a T-helper 1 response against melanocytes in the eye, inner ear, central nervous system, hair and skin. We describe a 20-year-old British–Honduran man with recent worsening headache and photophobia, vomiting and visual blurring. On examination, his pupils reacted sluggishly and visual acuities were bilaterally reduced. Optical coherence tomography showed gross retinal swelling and neurosensory detachments. MR scan of the brain was normal, but cerebrospinal fluid showed a reactive picture with 258 ×10 9 lymphocytes./L (normal ≤5×10 9 /L). Following treatment with immunosuppression (prednisolone, tacrolimus, mycophenolate mofetil, adalimumab), he made a full recovery. Clinicians should consider Vogt-Koyanagi-Harada disease in patients presenting with headache with acute profound visual loss. A prompt diagnosis and immunosuppressive therapy can lead to complete resolution.
Type of Medium:
Online Resource
ISSN:
1474-7758
,
1474-7766
DOI:
10.1136/practneurol-2018-002152
Language:
English
Publisher:
BMJ
Publication Date:
2019
detail.hit.zdb_id:
2075532-6
detail.hit.zdb_id:
2170881-2
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