title: Vogt-Koyanagi-Harada syndrome and keratoconjunctivitis sicca.
abstract: OBJECTIVE
  To discover a relationship between Vogt-Koyanagi-Harada (VKH) syndrome and Sjögren syndrome.
  
  
  METHODS
  Observational case-control study.
  
  
  METHODS
  Sixteen Italian patients with VKH syndrome and 16 controls with diffuse uveitis underwent tear analysis and rheumatologic evaluation. Biopsy specimens of the minor salivary glands were obtained or salivary gland scintigraphy was performed in patients with xerostomia.
  
  
  RESULTS
  The Schirmer test (P <.0001), break-up time (P <.0001), the Ferning test (P <.001), and fluorescein and rose bengal staining (P <.0001) resulted in changes in VKH. Biopsy was positive in two patients and scintigraphy in four. Human leukocyte antigen DR4 was found in 68.75% of VKH cases and in 83.3% of the cases with Schirmer test less than 3 mm.
  
  
  CONCLUSIONS
  The incidence of keratoconjunctivitis sicca was higher in VKH syndrome patients than in controls. Two patients satisfied the criteria for Sjögren syndrome, and two others had scintigraphy indicative of salivary gland involvement. The association of these two autoimmune disorders is suggested by the low incidence of VKH syndrome in Italy and might be related to HLA DR4.
authors.affiliation: Servizio Speciale di Immunovirologia Oculare-Dipartmento di Oftalmologia, Università degli Studi di Roma La Sapienza, Rome, Italy.
authors.forename: Paola Pivetti
authors.initials: PP
authors.lastname: Pezzi
authors.forename: Maria Pia
authors.initials: MP
authors.lastname: Paroli
authors.forename: Roberta
authors.initials: R
authors.lastname: Priori
authors.forename: Stefano
authors.initials: S
authors.lastname: Da Dalt
authors.forename: Raffaella
authors.initials: R
authors.lastname: Corradi
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D019793:Fluorescein; D015804:HLA-DR4 Antigen / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D012395:Rose Bengal; D012469:Salivary Glands / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D012859:Sjogren's Syndrome / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism; D013666:Tears / Q000378:metabolism; D014605:Uveitis / Q000150:complications; D014607:Uveomeningoencephalitic Syndrome / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism
chemical_list: D015804:HLA-DR4 Antigen; D012395:Rose Bengal; D019793:Fluorescein