title: Conjunctival nodules associated with Vogt-Koyanagi-Harada disease.
abstract: 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.
authors: 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
authors: Kumiko
authors: K
authors: Nakao
authors: Yuka
authors: Y
authors: Shimonagano
authors: Norihito
authors: N
authors: Doi
authors: Taiji
authors: T
authors: Sakamoto
mesh_terms: 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
chemical_list: D015703:Antigens, CD
references: Arch Ophthalmol. 2004 Dec;122(12):1878-81
references: 15596596
references: Am J Ophthalmol. 2001 May;131(5):647-52
references: 11336942
references: Ophthalmology. 1985 Apr;92(4):580-90
references: 3873634
references: Am J Ophthalmol. 1999 Sep;128(3):361-2
references: 10511034
references: Am J Ophthalmol. 1988 Jun 15;105(6):607-11
references: 3259837
references: Ophthalmology. 1983 Jan;90(1):76-95
references: 6338439
references: Curr Eye Res. 1990;9 Suppl:35-40
references: 1974489