Vogt-Koyanagi-Harada syndrome and keratoconjunctivitis sicca.
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.
Pezzi
Paola Pivetti
PP
Servizio Speciale di Immunovirologia Oculare-Dipartmento di Oftalmologia, Università degli Studi di Roma La Sapienza, Rome, Italy.
Paroli
Maria Pia
MP
Priori
Roberta
R
Da Dalt
Stefano
S
Corradi
Raffaella
R
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
D015804:HLA-DR4 Antigen; D012395:Rose Bengal; D019793:Fluorescein