Revised diagnostic criteria for vogt-koyanagi-harada disease: considerations on the different disease categories.
OBJECTIVE
To evalulate the applicability of the Revised Diagnostic Criteria for Vogt-Koyanagi-Harada (VKH) disease to Brazilian patients and to verify the association between different disease categories, clinical parameters, and the presence of HLA-DRB1*0405.


METHODS
A retrospective observational case series.


METHODS
Medical charts of 67 patients (10 to 64 years in age; 12 men and 55 women), from the Uveitis Service, Hospital das Clínicas, University of São Paulo School of Medicine (HCFMUSP), São Paulo, Brazil were reviewed. Patients, previously diagnosed with VKH disease using criteria proposed by the American Uveitis Society, underwent retrospective classification based on the Revised Diagnostic Criteria. The degree of concordance was assessed. At presentation, 46 patients (69%) were in the early phase. In this group, the mean time from disease onset to treatment was 15 days (range, one to 30 days). Forty-eight patients (72%) were typed for HLA-DRB1*0405 by polymerase chain reaction-sequence specific primer and polymerase chain reaction-sequence-specific oligonucleotides primer. Disease categories, phase at initial presentation, and ocular complications were analyzed.


RESULTS
There was a 100% of concordance between the two criteria. Disease was classified as complete in 10 patients (15%), incomplete in 37 patients (55%), and probable in 20 patients (30%). In each group, respectively, 90%, 76%, and 45% were in the early phase at presentation (P = .017). There was no association between disease categories, the presence of HLA-DRB1*0405, and clinical parameters.


CONCLUSIONS
The Revised Diagnostic Criteria proved useful for diagnosis of VKH disease in Brazilian patients. The present retrospective study did not find any association between disease category and severity parameters. To better understand the relevance of disease categories, a minimum follow-up period to categorize patients should be included in future prospective studies.
da Silva
Felipe Theodoro Bezerra Gaspar Carvalho
FT
Department of Ophthalmology, Uveitis Service, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil.
Damico
Francisco Max
FM
Marin
Maria Lucia
ML
Goldberg
Anna Carla
AC
Hirata
Carlos Eduardo
CE
Takiuti
Pedro Henrique
PH
Olivalves
Edilberto
E
Yamamoto
Joyce Hisae
JH
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005451:Fluorescein Angiography; D006684:HLA-DR Antigens / Q000235:genetics; D059811:HLA-DRB1 Chains; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D041623:Tomography, Optical Coherence; D014607:Uveomeningoencephalitic Syndrome / Q000145:classification* / Q000175:diagnosis* / Q000188:drug therapy / Q000235:genetics
D006684:HLA-DR Antigens; D059811:HLA-DRB1 Chains; C493960:HLA-DRB1*04:05 antigen; D007166:Immunosuppressive Agents