[Vogt-Koyanagi-Harada syndrome].
BACKGROUND
Vogt-Koyanagi-Harada syndrome is a rare, inflammatory disease with manifestations affecting the ocular, central nervous, audito-vestibular, and integumentary systems. Vogt-Koyanagi-Harada syndrome is more frequent in Asia but is also described in Europe. We report three new non asiatic cases of this syndrome.


METHODS
The three patients had bilateral panuveitis and hypoacusia. Two of them had peripheral facial palsy, two of them had vestibular syndrome and one of them lymphocytic meningitis. In each case we found characteristic HLA II typing and in one case we discovered the simultaneous presence of three auto-antibodies: anti-retina (anti-Arrestin type), anti-choroid and anti-cochlea. These patients were treated by corticosteroids but required an additional treatment by cyclophosphamide (0.8g/m2). The clinical course was favorable with visual sequelae for two and auditory one for one.


CONCLUSIONS
These biological and therapeutic elements and a review of the recent literature are in favor of an autoimmune origin of this syndrome.
Blanc
F
F
Clinique Neurologique, Hopitaux Universitaires, Strasbourg.
Fleury
M
M
Talmant
V
V
Deroide
N
N
Szwarcberg
J
J
Tranchant
C
C
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001323:Autoantibodies / Q000276:immunology; D002829:Choroid / Q000276:immunology; D003051:Cochlea / Q000276:immunology; D003520:Cyclophosphamide / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005158:Facial Paralysis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D034381:Hearing Loss / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015864:Panuveitis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D012160:Retina / Q000276:immunology; D014607:Uveomeningoencephalitic Syndrome / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology*; D015837:Vestibular Diseases / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology
D000893:Anti-Inflammatory Agents; D001323:Autoantibodies; D003520:Cyclophosphamide