Vogt-koyanagi-harada syndrome - A neurologist's perspective
Vogt-Koyanagi-Harada (VKH) syndrome is an immune-mediated granulomatous disease which affects melanin-rich organs like eyes, skin, nervous system, and ears. Neurological and auditory manifestations usually precede the involvement of other sites. Patients may manifest with “complete” or “incomplete”...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | Annals of Indian Academy of Neurology |
| Subjects: | |
| Online Access: | http://www.annalsofian.org/article.asp?issn=0972-2327;year=2021;volume=24;issue=3;spage=405;epage=409;aulast=Shivaram |
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| author | Sumanth Shivaram Madhu Nagappa Doniparthi V Seshagiri Jayanth Shimoga Shanthakumar Swayang Sudha Panda Ravi Anadure B N Nandeesh Yasha T Chickabasaviah Rose D Bharath Joy Vijayan Bakula Kashyap Sanjib Sinha Arun B Taly |
| author_facet | Sumanth Shivaram Madhu Nagappa Doniparthi V Seshagiri Jayanth Shimoga Shanthakumar Swayang Sudha Panda Ravi Anadure B N Nandeesh Yasha T Chickabasaviah Rose D Bharath Joy Vijayan Bakula Kashyap Sanjib Sinha Arun B Taly |
| author_sort | Sumanth Shivaram |
| collection | DOAJ |
| description | Vogt-Koyanagi-Harada (VKH) syndrome is an immune-mediated granulomatous disease which affects melanin-rich organs like eyes, skin, nervous system, and ears. Neurological and auditory manifestations usually precede the involvement of other sites. Patients may manifest with “complete” or “incomplete” syndrome. We report two patients who presented with acute headache and impaired vision. Fundus examination revealed optic disc hyperemia and exudative retinal detachment which provided a clue for the diagnosis at the bedside. Fundus fluorescein angiogram (FFA) revealed abnormal dye leakage, whereas B scan showed choroid thickening. Cerebrospinal fluid (CSF) pleocytosis contrasted with unremarkable brain magnetic resonance imaging and lack of meningeal signs. Melanophagocytosis was evidenced by melanin-laden macrophages in CSF and skin biopsy. This finding is specific for VKH syndrome and helps to clinch the diagnosis even when the complete syndrome is not present cross-sectionally. VKH syndrome should be suspected in patients with aseptic meningitis if tests for common infectious and immune-mediated diseases are negative. |
| first_indexed | 2024-12-19T17:35:58Z |
| format | Article |
| id | doaj.art-d2f72c93ca914e779d06262c0f0c161d |
| institution | Directory Open Access Journal |
| issn | 0972-2327 1998-3549 |
| language | English |
| last_indexed | 2024-12-19T17:35:58Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Annals of Indian Academy of Neurology |
| spelling | doaj.art-d2f72c93ca914e779d06262c0f0c161d2022-12-21T20:12:20ZengWolters Kluwer Medknow PublicationsAnnals of Indian Academy of Neurology0972-23271998-35492021-01-0124340540910.4103/aian.AIAN_405_20Vogt-koyanagi-harada syndrome - A neurologist's perspectiveSumanth ShivaramMadhu NagappaDoniparthi V SeshagiriJayanth Shimoga ShanthakumarSwayang Sudha PandaRavi AnadureB N NandeeshYasha T ChickabasaviahRose D BharathJoy VijayanBakula KashyapSanjib SinhaArun B TalyVogt-Koyanagi-Harada (VKH) syndrome is an immune-mediated granulomatous disease which affects melanin-rich organs like eyes, skin, nervous system, and ears. Neurological and auditory manifestations usually precede the involvement of other sites. Patients may manifest with “complete” or “incomplete” syndrome. We report two patients who presented with acute headache and impaired vision. Fundus examination revealed optic disc hyperemia and exudative retinal detachment which provided a clue for the diagnosis at the bedside. Fundus fluorescein angiogram (FFA) revealed abnormal dye leakage, whereas B scan showed choroid thickening. Cerebrospinal fluid (CSF) pleocytosis contrasted with unremarkable brain magnetic resonance imaging and lack of meningeal signs. Melanophagocytosis was evidenced by melanin-laden macrophages in CSF and skin biopsy. This finding is specific for VKH syndrome and helps to clinch the diagnosis even when the complete syndrome is not present cross-sectionally. VKH syndrome should be suspected in patients with aseptic meningitis if tests for common infectious and immune-mediated diseases are negative.http://www.annalsofian.org/article.asp?issn=0972-2327;year=2021;volume=24;issue=3;spage=405;epage=409;aulast=Shivaramaseptic meningitisbrain-eye-ear (bee) syndromesexudative retinal detachmentmelanin-laden macrophagespoliosisvogt-koyanagi-harada syndrome |
| spellingShingle | Sumanth Shivaram Madhu Nagappa Doniparthi V Seshagiri Jayanth Shimoga Shanthakumar Swayang Sudha Panda Ravi Anadure B N Nandeesh Yasha T Chickabasaviah Rose D Bharath Joy Vijayan Bakula Kashyap Sanjib Sinha Arun B Taly Vogt-koyanagi-harada syndrome - A neurologist's perspective Annals of Indian Academy of Neurology aseptic meningitis brain-eye-ear (bee) syndromes exudative retinal detachment melanin-laden macrophages poliosis vogt-koyanagi-harada syndrome |
| title | Vogt-koyanagi-harada syndrome - A neurologist's perspective |
| title_full | Vogt-koyanagi-harada syndrome - A neurologist's perspective |
| title_fullStr | Vogt-koyanagi-harada syndrome - A neurologist's perspective |
| title_full_unstemmed | Vogt-koyanagi-harada syndrome - A neurologist's perspective |
| title_short | Vogt-koyanagi-harada syndrome - A neurologist's perspective |
| title_sort | vogt koyanagi harada syndrome a neurologist s perspective |
| topic | aseptic meningitis brain-eye-ear (bee) syndromes exudative retinal detachment melanin-laden macrophages poliosis vogt-koyanagi-harada syndrome |
| url | http://www.annalsofian.org/article.asp?issn=0972-2327;year=2021;volume=24;issue=3;spage=405;epage=409;aulast=Shivaram |
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