Vogt-Koyanagi-Harada disease presenting initially as aseptic meningoencephalitis.
Vogt-Koyanagi-Harada (VKH) disease in a Gypsy woman was diagnosed 4 months after her initial complaints. The delay is explained by the facts that: (1) the characteristic ophthalmological symptoms, which usually herald the disease and ensure early diagnosis, developed only late during the course; and (2) only retrospective analysis of the cerebrospinal fluid (CSF) cell preparation proved the presence of melanin-laden macrophages (MLMs), specific for the syndrome. We emphasize that VKH syndrome may initially present as aseptic meningitis, without specific ophthalmological symptoms. In suspected cases a very detailed CSF cell analysis is needed, because the presence of MLMs could confirm the diagnosis. However, VKH syndrome has a much higher incidence in Asia; cases in other races, including white people in Europe, also occur.
Kamondi
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Department of Neurology, Faculty of Medicine, Semmelweis University of Budapest, 1083 Balassa u. 6, Budapest, Hungary. anita@neur.sote.hu
Szegedi
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Papp
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Seres
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Szirmai
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D000328:Adult; D016572:Cyclosporine / Q000627:therapeutic use; D003594:Cytoplasmic Granules / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008264:Macrophages / Q000473:pathology; D008543:Melanins / Q000134:cerebrospinal fluid; D008582:Meningitis, Aseptic / Q000175:diagnosis; D008590:Meningoencephalitis / Q000175:diagnosis; D008775:Methylprednisolone / Q000627:therapeutic use; D012008:Recurrence; D014607:Uveomeningoencephalitic Syndrome / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000188:drug therapy
D007166:Immunosuppressive Agents; D008543:Melanins; D016572:Cyclosporine; D008775:Methylprednisolone