title: Early manifestation of vogt-koyanagi-harada disease as unilateral posterior scleritis.
abstract: OBJECTIVE
  To describe a patient with an initial diagnosis of unilateral posterior scleritis who developed bilateral Vogt-Koyanagi-Harada (VKH) disease 12 months later.
  
  
  METHODS
  A 38-year-old woman was diagnosed with posterior scleritis in her right eye at successive examinations. The left eye showed no signs of ocular inflammation.
  
  
  METHODS
  Her right eye developed a second attack of posterior scleritis 3 months after the initial diagnosis. Twelve months after the first incident, granulomatous uveitis and sunset glow fundus were observed in both eyes. At the same time, lymphocytosis was found in the cerebrospinal fluid, and she was HLA DR-4-positive. In addition, poliosis was noted.
  
  
  CONCLUSIONS
  The final diagnosis was primarily VKH disease with presenting signs and symptoms of unilateral posterior scleritis. We therefore recommend that when following a patient with posterior scleritis include VKH disease in the differential diagnosis.
authors.affiliation: Department of Ophthalmology, Kanazawa Medical University, Uchinada, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Kouda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sasaki
authors.forename: Sachiko
authors.initials: S
authors.lastname: Harada
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Yamada
authors.forename: Nobuo
authors.initials: N
authors.lastname: Takahashi
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Sasaki
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D012163:Retinal Detachment / Q000209:etiology; D015423:Scleritis / Q000175:diagnosis / Q000209:etiology*; D014607:Uveomeningoencephalitic Syndrome / Q000150:complications* / Q000175:diagnosis