Conjunctival nodules associated with Vogt-Koyanagi-Harada disease.
BACKGROUND
To report on conjunctival nodules as an unusual manifestation of Vogt-Koyanagi-Harada disease.


METHODS
A 24-year-old woman presented with a two-month history of bilateral conjunctival injection and gradually decreased vision. Ophthalmological examinations revealed bilateral granulomatous uveitis and bulbar conjunctival nodules, and a biopsy of the conjunctival nodules was performed.


RESULTS
The biopsy specimens showed noncaseating granulomas. The major components of the infiltrating lymphocytes were CD8-positive T cells. Topical corticosteroid therapy reduced the anterior segment inflammation, and the conjunctival nodules disappeared within a week. Afterwards, the patient demonstrated bilateral retinal detachments, sunset glow fundus and alopecia, and, therefore, was diagnosed to have Vogt-Koyanagi-Harada disease four months after the first symptoms.


CONCLUSIONS
Conjunctival nodules may represent the primary manifestation of Vogt-Koyanagi-Harada disease.
Nakao
Kumiko
K
Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan. nakao@m2.kufm.kagoshima-u.ac.jp
Shimonagano
Yuka
Y
Doi
Norihito
N
Sakamoto
Taiji
T
D000328:Adult; D015703:Antigens, CD / Q000378:metabolism; D015496:CD4-Positive T-Lymphocytes / Q000473:pathology; D018414:CD8-Positive T-Lymphocytes / Q000473:pathology; D003229:Conjunctival Diseases / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D005260:Female; D006099:Granuloma / Q000175:diagnosis / Q000209:etiology* / Q000378:metabolism; D006801:Humans; D007124:Immunoenzyme Techniques; D014607:Uveomeningoencephalitic Syndrome / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism
D015703:Antigens, CD
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