Alezzandrini Syndrome Workup

  • Author: Camila K Janniger, MD; Chief Editor: William D James, MD   more...
 
Updated: May 27, 2011
 

Laboratory Studies

No laboratory studies are required. Diagnosis is based on the clinical presentation.

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Other Tests

Fundus examination is indicated. Fundus autofluorescence and spectral domain-optical coherence tomography imaging may facilitate improved assessment of retinal pigment epithelium and the outer retina.[17] Visual acuity test may be performed.

Audiometry may be required.

For Vogt-Koyanagi-Harada syndrome and other entities associated with uveitis, the positive predictive value of routinely applied HLA typing as a diagnostic test was judged to be of limited usefulness.[18]

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Contributor Information and Disclosures
Author

Camila K Janniger, MD  Clinical Professor of Dermatology, Clinical Associate Professor of Pediatrics, Chief of Pediatric Dermatology, University of Medicine and Dentistry of New Jersey-New Jersey Medical School

Camila K Janniger, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Coauthor(s)

Ewa Koziorynska, MD  Assistant Professor of Neurology, Comprehensive Epilepsy Center, State University of New York Downstate Medical Center

Ewa Koziorynska, MD is a member of the following medical societies: Sigma Xi

Disclosure: none None None

Specialty Editor Board

Noah S Scheinfeld, MD, JD, FAAD  Assistant Clinical Professor, Department of Dermatology, Columbia University College of Physicians and Surgeons; Consulting Staff, Department of Dermatology, St Luke's Roosevelt Hospital Center, Beth Israel Medical Center, and New York Eye and Ear Infirmary; Private Practice

Noah S Scheinfeld, MD, JD, FAAD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Optigenex Consulting fee Independent contractor

Michael J Wells, MD  Associate Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine

Michael J Wells, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, and Texas Medical Association

Disclosure: Nothing to disclose.

Robert A Schwartz, MD, MPH  Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, University of Medicine and Dentistry of New Jersey-New Jersey Medical School

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and Sigma Xi

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

William D James, MD  Paul R Gross Professor of Dermatology, University of Pennsylvania School of Medicine; Vice-Chair, Program Director, Department of Dermatology, University of Pennsylvania Health System

William D James, MD is a member of the following medical societies: American Academy of Dermatology and Society for Investigative Dermatology

Disclosure: Elsevier Royalty Other

References

  1. Casala AM, Alezzandrini AA. Vitiligo, poliosis unilateral con retinitis pigmentaria y hypoacusia. Arch Argent Dermatol. 1959;9:449.

  2. Alezzandrini AA. [Unilateral manifestations of tapeto-retinal degeneration, vitiligo, poliosis, grey hair and hypoacousia]. Ophthalmologica. 1964;147:409-19. [Medline].

  3. Barnes L. Vitiligo and the Vogt-Koyanagi-Harada syndrome. Dermatol Clin. Apr 1988;6(2):229-39. [Medline].

  4. Vogt A. Fruhzeities ergraven der zilien und bemerkungen uber den sogenannten plotzlichen einendieser veranderugn. Klin Monatsbl Augenheilkd. 1906;44:228.

  5. Gilbert W. Vitiligo und Auge, ein Beitrag zur Kenntnis der herpetischen augeenerkran kunger. Klin Monatsbl Augenheilkd. 1910;48:24.

  6. Harada E. Clinical study of nonsuppurative choroiditis: A report of acute diffuse choroiditis. Acta Soc Opthalmol Jpn. 1926;30:356.

  7. Koyanagi Y. Dysakusis, Alopecia, und Poliosis beschwerer Uveitis nicht traumatischen Ursprunge. Klin Monatsbl Augenheilkd. 1929;82:194.

  8. Kodjikian L, Seve P, Le Hoang P, Garweg JG. Atypical Vogt-Koyanagi-Harada disease or new uveomeningitic syndrome?. Graefes Arch Clin Exp Ophthalmol. Mar 2005;243(3):263-5. [Medline].

  9. Du L, Yang P, Hou S, Lin X, Zhou H, Huang X, et al. Association of the CTLA-4 gene with Vogt-Koyanagi-Harada syndrome. Clin Immunol. Apr 2008;127(1):43-8. [Medline].

  10. Hoffman MD, Dudley C. Suspected Alezzandrini's syndrome in a diabetic patient with unilateral retinal detachment and ipsilateral vitiligo and poliosis. J Am Acad Dermatol. Mar 1992;26(3 Pt 2):496-7. [Medline].

  11. Shamsadini S, Meshkat MR, Mozzafarinia K. Bilateral retinal detachment in Alezzandrini's syndrome. Int J Dermatol. Dec 1994;33(12):885-6. [Medline].

  12. Andrade A, Pithon M. Alezzandrini syndrome: report of a sixth clinical case. Dermatology. Feb 2011;222(1):8-9. [Medline].

  13. Haque WM, Mir MR, Hsu S. Vogt-Koyanagi-Harada syndrome: Association with alopecia areata. Dermatol Online J. 2009;15(12):10. [Medline].

  14. Lorincz AL. Disturbances of melanin pigmentation. In: Moschella SL, Hurley JH, eds. Dermatology. Philadelphia, Pa: WB Saunders; 1985.

  15. Rao NA, Gupta A, Dustin L, Chee SP, Okada AA, Khairallah M, et al. Frequency of distinguishing clinical features in Vogt-Koyanagi-Harada disease. Ophthalmology. Mar 2010;117(3):591-9, 599.e1. [Medline]. [Full Text].

  16. Huggins RH, Janusz CA, Schwartz RA. Vitiligo: a sign of systemic disease. Indian J Dermatol Venereol Leprol. Jan-Feb 2006;72(1):68-71. [Medline].

  17. Vasconcelos-Santos DV, Sohn EH, Sadda S, Rao NA. Retinal pigment epithelial changes in chronic Vogt-Koyanagi-Harada disease: fundus autofluorescence and spectral domain-optical coherence tomography findings. Retina. Jan 2010;30(1):33-41. [Medline].

  18. Zamecki KJ, Jabs DA. HLA typing in uveitis: use and misuse. Am J Ophthalmol. Feb 2010;149(2):189-193.e2. [Medline].

  19. Raffa L, Bawazeer A. Intravitreal bevacizumab injection in a 14-year-old Vogt-Koyanagi-Harada patient with choroidal neovascular membrane. Can J Ophthalmol. 2009;44:615-6. [Medline].

  20. Khalifa YM, Bailony MR, Acharya NR. Treatment of pediatric vogt-koyanagi-harada syndrome with infliximab. Ocul Immunol Inflamm. Jun 2010;18(3):218-22. [Medline].

  21. Chee SP, Jap A, Bacsal K. Prognostic factors of Vogt-Koyanagi-Harada disease in Singapore. Am J Ophthalmol. Jan 2009;147(1):154-161.e1. [Medline].

 
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Gray forelock and vitiligo on the forehead in a patient with Alezzandrini syndrome.
 
 
 
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