Vogt-Koyanagi-Harada Syndrome Workup

  • Author: Anna Choczaj-Kukula, MD, PhD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Aug 30, 2011
 

Laboratory Studies

  • For quick diagnosis and early treatment, Vogt-Koyanagi-Harada (VKH) syndrome requires a multidisciplinary management strategy involving dermatologists and ophthalmologists.
  • Perform neurologic examination with lumbar puncture to detect associated abnormalities.[36]
  • Detailed CSF cell analysis is necessary. Changes in the CSF include pleocytosis with the presence of melanin-laden macrophages (specific for the syndrome and helpful in confirming the diagnosis), increased protein levels, and increased pressure.
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Imaging Studies

  • Standardized A-scan and contact B-scan echography, performed by ophthalmologist
  • Orbital MRI[37]
  • Brain MRI[37, 38]
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Procedures

  • Perform fluorescein angiography, which shows multiple hypofluorescent areas in the retina at the level of the retinal pigment epithelium.[39]
  • Perform indocyanine green choroidal angiography.[40]
  • Audiometry may reveal sensorineural hearing loss.
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Histologic Findings

A skin biopsy specimen taken a month after the onset of VKH syndrome ocular symptoms will likely reveal a mononuclear infiltrate concentrated in the area of hair follicles and sweat glands, consisting mostly of T lymphocytes with a small number of B cells. In depigmented skin, the absence of melanin, as anticipated in vitiligo, can be noted. Vasodilatation in the dermis, pigment-laden macrophages, and a lymphocytic infiltrate have also been described.

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Contributor Information and Disclosures
Author

Anna Choczaj-Kukula, MD, PhD  Locum Consultant Dermatologist, St John's Institute of Dermatology, St Thomas' Hospital, UK

Anna Choczaj-Kukula, MD, PhD is a member of the following medical societies: American Academy of Dermatology, British Association of Dermatologists, European Academy of Dermatology and Venereology, and Royal Society of Medicine

Disclosure: Johnson & Johnson Salary Management position

Coauthor(s)

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.

Specialty Editor Board

Janet Fairley, MD  Professor and Head, Department of Dermatology, University of Iowa, Roy J and Lucille A Carver College of Medicine

Janet Fairley, MD is a member of the following medical societies: American Academy of Dermatology, American Dermatological Association, American Federation for Medical Research, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

David F Butler, MD  Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa

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.

Glen H Crawford, MD  Assistant Clinical Professor, Department of Dermatology, University of Pennsylvania School of Medicine; Chief, Division of Dermatology, The Pennsylvania Hospital

Glen H Crawford, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Phi Beta Kappa, and Society of USAF Flight Surgeons

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

  1. PATTISON EM. UVEOMENINGOENCEPHALITIC SYNDROME (VOGT-KOYANAGI-HARADA). Arch Neurol. Feb 1965;12:197-205. [Medline].

  2. Vogt A. Frühzeitiges Ergrauen der Zilien und Bemerkungen uber den sogenannten plötzlichen Eintritt dieser Veranderung. Klin Monatsbl Augenheilk. 1906;44:228-42.

  3. Harada E. On the acute diffuse choroiditis. Acta Soc Ophthalmol Jpn. 1926;30:356-78.

  4. Koyanagi Y. Dysakusis, Alopecia und Poliosis bei schwerer Uveitis nicht traumatischen Ursprungs. Klin Monatsbl Augenheilk. 1929;82:194-211.

  5. Babel J. Syndrome de Vogt-Koyanagi. Schweiz Med Wochenscher. 1932;44:1136.

  6. Sunakawa M, Okinami S. Epstein-Barr virus-related antibody pattern in uveitis. Jpn J Ophthalmol. 1985;29(4):423-8. [Medline].

  7. Schlaegel TF Jr, Morris WR. Viruslike inclusion bodies in subretinal fluid in uveo-encephalitis. Am J Ophthalmol. Dec 1964;58:940-5. [Medline].

  8. Kondo I, Yamagata K, Yamaki K, Sakuragi S. [Analysis of the candidate antigen for Harada's disease]. Nihon Ganka Gakkai Zasshi. Jun 1994;98(6):596-603. [Medline].

  9. Yamaki K, Gocho K, Hayakawa K, Kondo I, Sakuragi S. Tyrosinase family proteins are antigens specific to Vogt-Koyanagi-Harada disease. J Immunol. Dec 15 2000;165(12):7323-9. [Medline].

  10. Gloddek B, Lassmann S, Gloddek J, Arnold W. Role of S-100beta as potential autoantigen in an autoimmune disease of the inner ear. J Neuroimmunol. Nov 1 1999;101(1):39-46. [Medline].

  11. El-Asrar AM, Struyf S, Kangave D, Al-Obeidan SS, Opdenakker G, Geboes K, et al. Cytokine profiles in aqueous humor of patients with different clinical entities of endogenous uveitis. Clin Immunol. May 2011;139(2):177-84. [Medline].

  12. Chi W, Yang P, Li B, et al. IL-23 promotes CD4+ T cells to produce IL-17 in Vogt-Koyanagi-Harada disease. J Allergy Clin Immunol. May 2007;119(5):1218-24. [Medline].

  13. Kluger N, Mura F, Guillot B, Bessis D. Vogt-koyanagi-harada syndrome associated with psoriasis and autoimmune thyroid disease. Acta Derm Venereol. 2008;88(4):397-8. [Medline].

  14. Al Hemidan AI, Tabbara KF, Althomali T. Vogt-Koyanagi-Harada associated with diabetes mellitus and celiac disease in a 3-year-old girl. Eur J Ophthalmol. Jan-Feb 2006;16(1):173-7. [Medline].

  15. Suzuki H, Isaka M, Suzuki S. Type 1 diabetes mellitus associated with Graves' disease and Vogt-Koyanagi-Harada syndrome. Intern Med. 2008;47(13):1241-4. [Medline].

  16. Najman-Vainer J, Levinson RD, Graves MC, Nguyen BT, Engstrom RE Jr, Holland GN. An association between Vogt-Koyanagi-Harada disease and Guillain-Barré syndrome. Am J Ophthalmol. May 2001;131(5):615-9. [Medline].

  17. Matsuo T, Masuda I, Ota K, Yamadori I, Sunami R, Nose S. Vogt-Koyanagi-Harada syndrome in two patients with immunoglobulin A nephropathy. Acta Med Okayama. Oct 2007;61(5):305-9. [Medline].

  18. Tabbara KF. Vogt-Koyanagi-Harada syndrome after cutaneous injury. Ophthalmology. Oct 1999;106(10):1854-5. [Medline].

  19. Rathinam SR, Namperumalsamy P, Nozik RA, Cunningham ET Jr. Vogt-Koyanagi-Harada syndrome after cutaneous injury. Ophthalmology. Mar 1999;106(3):635-8. [Medline].

  20. Donaldson RC, Canaan SA Jr, McLean RB, Ackerman LV. Uveitis and vitiligo associated with BCG treatment for malignant melanoma. Surgery. Nov 1974;76(5):771-8. [Medline].

  21. Sober AJ, Haynes HA. Uveitis, poliosis, hypomelanosis, and alopecia in a patient with malignant melanoma. Arch Dermatol. Mar 1978;114(3):439-41. [Medline].

  22. Accorinti M, Pirraglia MP, Corsi C, Caggiano C. Vogt-Koyanagi-Harada disease after head trauma. Eur J Ophthalmol. Sep-Oct 2007;17(5):847-52. [Medline].

  23. Hashida N, Kanayama S, Kawasaki A, Ogawa K. A case of vogt-koyanagi-harada disease associated with malignant lymphoma. Jpn J Ophthalmol. May-Jun 2005;49(3):253-6. [Medline].

  24. Pahk PJ, Todd DJ, Blaha GR, et al. Intravascular lymphoma masquerading as Vogt-Koyanagi-Harada syndrome. Ocul Immunol Inflamm. May-Jun 2008;16(3):123-6. [Medline].

  25. Horie Y, Takemoto Y, Miyazaki A, et al. Tyrosinase gene family and Vogt-Koyanagi-Harada disease in Japanese patients. Mol Vis. Dec 20 2006;12:1601-5. [Medline].

  26. Hou S, Yang P, Du L, et al. Small ubiquitin-like modifier 4 (SUMO4) polymorphisms and Vogt-Koyanagi-Harada (VKH) syndrome in the Chinese Han population. Mol Vis. 2008;14:2597-603. [Medline].

  27. Pivetti-Pezzi P, Accorinti M, Colabelli-Gisoldi RA, Pirraglia MP. Vogt-Koyanagi-Harada disease and HLA type in Italian patients. Am J Ophthalmol. Dec 1996;122(6):889-91. [Medline].

  28. Abad S, Monnet D, Caillat-Zucman S, et al. Characteristics of Vogt-Koyanagi-Harada disease in a French cohort: ethnicity, systemic manifestations, and HLA genotype data. Ocul Immunol Inflamm. Jan-Feb 2008;16(1):3-8. [Medline].

  29. Yi X, Yang P, Sun M, Yang Y, Li F. Decreased 1,25-Dihydroxyvitamin D3 level is involved in the pathogenesis of Vogt-Koyanagi-Harada (VKH) disease. Mol Vis. Mar 9 2011;17:673-9. [Medline]. [Full Text].

  30. 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].

  31. Ostergaard J, Goldschmidt E, Andersen N. Vogt-Koyanagi-Harada syndrome in a Greenlandic Inuit. Acta Ophthalmol. Aug 2008;86(5):576-8. [Medline].

  32. Berker N, Ozdamar Y, Soykan E, Ozdal P, Ozkan SS. Vogt-Koyanagi-Harada syndrome in children: report of a case and review of the literature. Ocul Immunol Inflamm. Jul-Aug 2007;15(4):351-7. [Medline].

  33. Read RW, Holland GN, Rao NA, et al. Revised diagnostic criteria for Vogt-Koyanagi-Harada disease: report of an international committee on nomenclature. Am J Ophthalmol. May 2001;131(5):647-52. [Medline].

  34. Nordlund JJ, Albert D, Forget B, Lerner AB. Halo nevi and the Vogt-Koyanagi-Harada syndrome. Manifestations of vitiligo. Arch Dermatol. Jun 1980;116(6):690-2. [Medline].

  35. Goldberg AC, Yamamoto JH, Chiarella JM, et al. HLA-DRB1*0405 is the predominant allele in Brazilian patients with Vogt-Koyanagi-Harada disease. Hum Immunol. Mar 1998;59(3):183-8. [Medline].

  36. Kitaichi N, Matoba H, Ohno S. The positive role of lumbar puncture in the diagnosis of Vogt-Koyanagi-Harada disease: lymphocyte subsets in the aqueous humor and cerebrospinal fluid. Int Ophthalmol. Apr-Jun 2007;27(2-3):97-103. [Medline].

  37. Lohman BD, Gustafson CA, McKinney AM, Sarikaya B, Silbert SC. MR Imaging of Vogt-Koyanagi-Harada Syndrome with Leptomeningeal Enhancement. AJNR Am J Neuroradiol. Nov 24 2010;[Medline].

  38. Han HJ, Kim HY, Park JH, Lee EJ, Kim do G, Shin DI. Magnetic resonance imaging of pachymeningeal enhancement in Vogt-Koyanagi-Harada disease. Neurol Sci. Dec 2010;31(6):785-8. [Medline].

  39. Arellanes-Garcia L, Hernandez-Barrios M, Fromow-Guerra J, Cervantes-Fanning P. Fluorescein fundus angiographic findings in Vogt-Koyanagi-Harada syndrome. Int Ophthalmol. Apr-Jun 2007;27(2-3):155-61. [Medline].

  40. Wu W, Wen F, Huang S, Luo G, Wu D. Indocyanine green angiographic findings of Dalen-Fuchs nodules in Vogt-Koyanagi-Harada disease. Graefes Arch Clin Exp Ophthalmol. Jul 2007;245(7):937-40. [Medline].

  41. Denoyer A, Le Lez ML, Arsene S, Pisella PJ. [Repeated pulse corticosteroid therapy in Vogt-Koyanagi-Harada disease. A case report]. J Fr Ophtalmol. Apr 2004;27(4):404-8. [Medline].

  42. Kim SJ, Yu HG. The use of low-dose azathioprine in patients with Vogt-Koyanagi-Harada disease. Ocul Immunol Inflamm. Sep-Oct 2007;15(5):381-7. [Medline].

  43. Agarwal M, Ganesh SK, Biswas J. Triple agent immunosuppressive therapy in Vogt-Koyanagi-Harada syndrome. Ocul Immunol Inflamm. Dec 2006;14(6):333-9. [Medline].

  44. Choudhary A, Harding SP, Bucknall RC, Pearce IA. Mycophenolate mofetil as an immunosuppressive agent in refractory inflammatory eye disease. J Ocul Pharmacol Ther. Jun 2006;22(3):168-75. [Medline].

  45. Tellier Z. Human immunoglobulins in intraocular inflammation. Ann N Y Acad Sci. Sep 2007;1110:337-47. [Medline].

  46. Gonzalez-Delgado M, Gonzalez C, Blazquez JI, Salas-Puig J, Castro J, Hernandez-Lahoz C. [Intravenous immunoglobulin therapy in Vogt-Koyanagi-Harada syndrome]. Neurologia. Sep 2004;19(7):401-3. [Medline].

  47. Wang Y, Gaudio PA. Infliximab therapy for 2 patients with Vogt-Koyanagi-Harada syndrome. Ocul Immunol Inflamm. Jul-Aug 2008;16(4):167-71. [Medline].

  48. Kahn P, Weiss M, Imundo LF, Levy DM. Favorable response to high-dose infliximab for refractory childhood uveitis. Ophthalmology. May 2006;113(5):860-4.e2. [Medline].

  49. Moreker MR, Lodhi SA, Pathengay A. Role of intravitreal triamcinolone as an adjuvant in the management of Vogt-Koyanagi-Harada disease. Indian J Ophthalmol. Nov-Dec 2007;55(6):479-80. [Medline].

  50. Perente I, Utine CA, Cakir H, Kaya V, Tutkun IT, Yilmaz OF. Management of ocular complications of Vogt-Koyanagi-Harada syndrome. Int Ophthalmol. Feb 2009;29(1):33-7. [Medline].

  51. Al-Kharashi AS, Aldibhi H, Al-Fraykh H, Kangave D, Abu El-Asrar AM. Prognostic factors in Vogt-Koyanagi-Harada disease. Int Ophthalmol. Apr-Jun 2007;27(2-3):201-10. [Medline].

  52. Alaez C, del Pilar Mora M, Arellanes L, et al. Strong association of HLA class II sequences in Mexicans with Vogt-Koyanagi-Harada's disease. Hum Immunol. Sep 1999;60(9):875-82. [Medline].

  53. Anadol AZ, Akin M, Kurukahvecioglu O, Ersoy E. Vogt-Koyanagi-Harada syndrome and mesenteric ischemia: a case report. Adv Ther. Jul-Aug 2007;24(4):863-7. [Medline].

  54. Andreoli CM, Foster CS. Vogt-Koyanagi-Harada disease. Int Ophthalmol Clin. Spring 2006;46(2):111-22. [Medline].

  55. Ashkenazi I, Gutman I, Melamed S, Bartov E, Blumenthal M. Vogt-Koyanagi-Harada syndrome in two siblings. Metab Pediatr Syst Ophthalmol. 1991;14(3-4):64-7. [Medline].

  56. Attia S, Zaouali S, Bettaieb A, Yahia SB, Khairallah M. Peripheral iris depigmentation and ocular hypotony: result of the natural course of non-treated Vogt-Koyanagi-Harada (VKH) disease. Int Ophthalmol. Apr-Jun 2007;27(2-3):221-2. [Medline].

  57. Bacsal K, Wen DS, Chee SP. Concomitant choroidal inflammation during anterior segment recurrence in Vogt-Koyanagi-Harada disease. Am J Ophthalmol. Mar 2008;145(3):480-486. [Medline].

  58. Beniz J, Forster DJ, Lean JS, Smith RE, Rao NA. Variations in clinical features of the Vogt-Koyanagi-Harada syndrome. Retina. 1991;11(3):275-80. [Medline].

  59. Bykhovskaya I, Thorne JE, Kempen JH, Dunn JP, Jabs DA. Vogt-Koyanagi-Harada disease: clinical outcomes. Am J Ophthalmol. Oct 2005;140(4):674-8. [Medline].

  60. Chan CC, Palestine AG, Nussenblatt RB, Roberge FG, Benezra D. Anti-retinal auto-antibodies in Vogt-Koyanagi-Harada syndrome, Behcet's disease, and sympathetic ophthalmia. Ophthalmology. Aug 1985;92(8):1025-8. [Medline].

  61. Chee SP, Jap A, Bacsal K. Spectrum of Vogt-Koyanagi-Harada disease in Singapore. Int Ophthalmol. Apr-Jun 2007;27(2-3):137-42. [Medline].

  62. Chen L, Yang P, Zhou H, et al. Diminished frequency and function of CD4+CD25high regulatory T cells associated with active uveitis in Vogt-Koyanagi-Harada syndrome. Invest Ophthalmol Vis Sci. Aug 2008;49(8):3475-82. [Medline].

  63. Cho JH, Ahn JY, Byeon SH, Huh JS. Thunderclap headache as initial manifestation of Vogt-Koyanagi-Harada disease. Headache. Jan 2008;48(1):153-5. [Medline].

  64. Dahbour SS. MRI documented acute myelitis in a patient with Vogt-Koyanagi-Harada syndrome: first report. Clin Neurol Neurosurg. Feb 2009;111(2):200-2. [Medline].

  65. Damico FM, Cunha-Neto E, Goldberg AC, et al. T-cell recognition and cytokine profile induced by melanocyte epitopes in patients with HLA-DRB1*0405-positive and -negative Vogt-Koyanagi-Harada uveitis. Invest Ophthalmol Vis Sci. Jul 2005;46(7):2465-71. [Medline].

  66. Damico FM, Kiss S, Young LH. Vogt-Koyanagi-Harada disease. Semin Ophthalmol. Jul-Sep 2005;20(3):183-90. [Medline].

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

  68. Fang W, Zhou H, Yang P, Huang X, Wang L, Kijlstra A. Longitudinal quantification of aqueous flare and cells in Vogt-Koyanagi-Harada disease. Br J Ophthalmol. Feb 2008;92(2):182-5. [Medline].

  69. Fardeau C, Tran TH, Gharbi B, Cassoux N, Bodaghi B, LeHoang P. Retinal fluorescein and indocyanine green angiography and optical coherence tomography in successive stages of Vogt-Koyanagi-Harada disease. Int Ophthalmol. Apr-Jun 2007;27(2-3):163-72. [Medline].

  70. Gallagher MJ, Yilmaz T, Cervantes-Castaneda RA, Foster CS. The characteristic features of optical coherence tomography in posterior uveitis. Br J Ophthalmol. Dec 2007;91(12):1680-5. [Medline].

  71. Garcia LA, Carroll MO, Garza Leon MA. Vogt-Koyanagi-Harada syndrome in childhood. Int Ophthalmol Clin. Summer 2008;48(3):107-17. [Medline].

  72. Ghosh AK, Bhaduri G, Deb A, Singh M, Das K. Vogt-Koyanagi-Harada syndrome in a 10-year-old child. J Indian Med Assoc. Apr 2007;105(4):210, 212. [Medline].

  73. Gupta A, Kamal S, Gupta V, Bambery P, Kaura B. HLA typing in Vogt-Koyanagi-Harada syndrome in North Indian patients. Ocul Immunol Inflamm. Mar-Apr 2007;15(2):89-97. [Medline].

  74. Gupta V, Gupta A, Bambery P, Radotra BD, Pandav SS. Vogt-Koyanagi-Harada syndrome following injury-induced progressive vitiligo. Indian J Ophthalmol. Mar 2001;49(1):53-5. [Medline].

  75. Gupta V, Gupta A, Gupta P, Sharma A. Spectral-domain cirrus optical coherence tomography of choroidal striations seen in the acute stage of Vogt-Koyanagi-Harada disease. Am J Ophthalmol. Jan 2009;147(1):148-153.e2. [Medline].

  76. Hayasaka Y, Hayasaka S. Almost simultaneous onset of Vogt-Koyanagi-Harada syndrome in co-workers, friends, and neighbors. Graefes Arch Clin Exp Ophthalmol. Jul 2004;242(7):611-3. [Medline].

  77. Herbort CP, Mochizuki M. Vogt-Koyanagi-Harada disease: inquiry into the genesis of a disease name in the historical context of Switzerland and Japan. Int Ophthalmol. Apr-Jun 2007;27(2-3):67-79. [Medline].

  78. Horie Y, Kitaichi N, Takemoto Y, et al. Polymorphism of IFN-gamma gene and Vogt-Koyanagi-Harada disease. Mol Vis. Dec 21 2007;13:2334-8. [Medline].

  79. 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].

  80. Igawa K, Endo H, Yokozeki H, Nishioka K, Kawaguchi T. Alopecia in Vogt-Koyanagi-Harada syndrome. J Eur Acad Dermatol Venereol. Feb 2006;20(2):236-8. [Medline].

  81. Ikeda N, Hayasaka S, Kadoi C, Nagaki Y. Vogt-Koyanagi-Harada syndrome in an 11-year-old Boy. Ophthalmologica. 1999;213(3):197-9. [Medline].

  82. Itho S, Kurimoto S, Kouno T. Vogt-Koyanagi-Harada disease in monozygotic twins. Int Ophthalmol. Jan 1992;16(1):49-54. [Medline].

  83. Jap A, Luu CD, Yeo I, Chee SP. Correlation between peripapillary atrophy and corticosteroid therapy in patients with Vogt-Koyanagi-Harada disease. Eye. Feb 2008;22(2):240-5. [Medline].

  84. Khairallah M, Rao NA, Ben Yahia S, Zaouali S, Attia S. Pseudotumoral retinal pigment epithelium proliferation in a patient with Vogt-Koyanagi-Harada disease. Arch Ophthalmol. Sep 2006;124(9):1366-7. [Medline].

  85. Khoury T, Gonzalez-Fernandez F, Munschauer FE 3rd, Ostrow P. A 47-year-old man with sudden onset of blindness, pleocytosis, and temporary hearing loss. Vogt-Koyanagi-Harada syndrome (Uveomeningoencephalitic syndrome). Arch Pathol Lab Med. Jul 2006;130(7):1070-2. [Medline].

  86. Kim LA, Khurana RN, Parikh JG, Rao NA. Melanin-laden macrophages in the CSF to diagnose Vogt-Koyanagi-Harada simulating ocular syphilis. Ocul Immunol Inflamm. Jan-Feb 2008;16(1):59-61. [Medline].

  87. Kiyomoto C, Imaizumi M, Kimoto K, Abe H, Nakano S, Nakatsuka K. Vogt-Koyanagi-Harada disease in elderly Japanese patients. Int Ophthalmol. Apr-Jun 2007;27(2-3):149-53. [Medline].

  88. Kobayashi H, Kokubo T, Takahashi M, et al. Tyrosinase epitope recognized by an HLA-DR-restricted T-cell line from a Vogt-Koyanagi-Harada disease patient. Immunogenetics. Apr 1998;47(5):398-403. [Medline].

  89. Kosma KK, Kararizou E, Markou I, et al. Headache as a first manifestation of Vogt-Koyanagi-Harada disease. Med Princ Pract. 2008;17(3):253-4. [Medline].

  90. Lambe T, Leung JC, Bouriez-Jones T, et al. CD4 T cell-dependent autoimmunity against a melanocyte neoantigen induces spontaneous vitiligo and depends upon Fas-Fas ligand interactions. J Immunol. Sep 1 2006;177(5):3055-62. [Medline].

  91. Liu L, Yang P, He H, et al. Leptin increases in Vogt-Koyanagi-Harada (VKH) disease and promotes cell proliferation and inflammatory cytokine secretion. Br J Ophthalmol. Apr 2008;92(4):557-61. [Medline].

  92. Lubin JR, Loewenstein JI, Frederick AR Jr. Vogt-Koyanagi-Harada syndrome with focal neurologic signs. Am J Ophthalmol. Mar 1981;91(3):332-41. [Medline].

  93. Mantovani A, Resta A, Herbort CP, et al. Work-up, diagnosis and management of acute Vogt-Koyanagi-Harada disease: a case of acute myopization with granulomatous uveitis. Int Ophthalmol. Apr-Jun 2007;27(2-3):105-15. [Medline].

  94. Mantovani A, Resta A, Herbort CP, et al. Work-up, diagnosis and management of acute Vogt-Koyanagi-Harada disease: a case of acute myopization with granulomatous uveitis. Int Ophthalmol. Apr-Jun 2007;27(2-3):105-15. [Medline].

  95. Miyanaga M, Kawaguchi T, Shimizu K, Miyata K, Mochizuki M. Influence of early cerebrospinal fluid-guided diagnosis and early high-dose corticosteroid therapy on ocular outcomes of Vogt-Koyanagi-Harada disease. Int Ophthalmol. Apr-Jun 2007;27(2-3):183-8. [Medline].

  96. Mondkar SV, Biswas J, Ganesh SK. Analysis of 87 cases with Vogt-Koyanagi-Harada disease. Jpn J Ophthalmol. May-Jun 2000;44(3):296-301. [Medline].

  97. Montero JA, Sanchis ME, Fernandez-Munoz M. Vogt-Koyanagi-Harada syndrome in a case of multiple sclerosis. J Neuroophthalmol. Mar 2007;27(1):36-40. [Medline].

  98. Nakamura H, Tsukamoto H, Shibahara R, Nagai M, Mishima HK. Ultrasound biomicroscopy in the management of Vogt-Koyanagi-Harada disease. Acta Ophthalmol Scand. Dec 2000;78(6):718-9. [Medline].

  99. Nakamura S, Nakazawa M, Yoshioka M, et al. Melanin-laden macrophages in cerebrospinal fluid in Vogt-Koyanagi-Harada syndrome. Arch Ophthalmol. Oct 1996;114(10):1184-8. [Medline].

  100. Nakao K, Shimonagano Y, Doi N, Sakamoto T. Conjunctival nodules associated with Vogt-Koyanagi-Harada disease. Graefes Arch Clin Exp Ophthalmol. Sep 2007;245(9):1383-6. [Medline].

  101. Ondrey FG, Moldestad E, Mastroianni MA, et al. Sensorineural hearing loss in Vogt-Koyanagi-Harada syndrome. Laryngoscope. Oct 2006;116(10):1873-6. [Medline].

  102. Ozdirim E, Renda Y, Baytok V. Vogt-Koyanagi-Harada syndrome in siblings (with a brief review of the literature). Eur J Pediatr. Dec 1980;135(2):217-9. [Medline].

  103. Paredes I, Ahmed M, Foster CS. Immunomodulatory therapy for Vogt-Koyanagi-Harada patients as first-line therapy. Ocul Immunol Inflamm. Apr 2006;14(2):87-90. [Medline].

  104. Park S, Albert DM, Bolognia JL. Ocular manifestations of pigmentary disorders. Dermatol Clin. Jul 1992;10(3):609-22. [Medline].

  105. Perry HD, Font RL. Clinical and histopathologic observations in severe Vogt-Koyanagi-Harada syndrome. Am J Ophthalmol. Feb 1977;83(2):242-54. [Medline].

  106. Pezzi PP, Paroli MP, Priori R, Da Dalt S, Corradi R. Vogt-Koyanagi-Harada syndrome and keratoconjunctivitis sicca. Am J Ophthalmol. Apr 2004;137(4):769-70. [Medline].

  107. Pras E, Neumann R, Zandman-Goddard G, et al. Intraocular inflammation in autoimmune diseases. Semin Arthritis Rheum. Dec 2004;34(3):602-9. [Medline].

  108. Prignano F, Betts CM, Lotti T. Vogt-Koyanagi-Harada disease and vitiligo: where does the illness begin?. J Electron Microsc (Tokyo). Jan 2008;57(1):25-31. [Medline].

  109. Rajendram R, Evans M, Rao NA. Vogt-Koyanagi-Harada disease. Int Ophthalmol Clin. Spring 2005;45(2):115-34. [Medline].

  110. Rao NA. Pathology of Vogt-Koyanagi-Harada disease. Int Ophthalmol. Apr-Jun 2007;27(2-3):81-5. [Medline].

  111. Rao NA. Treatment of Vogt-Koyanagi-Harada disease by corticosteroids and immunosuppressive agents. Ocul Immunol Inflamm. Apr 2006;14(2):71-2. [Medline].

  112. Rao NA, Sukavatcharin S, Tsai JH. Vogt-Koyanagi-Harada disease diagnostic criteria. Int Ophthalmol. Apr-Jun 2007;27(2-3):195-9. [Medline].

  113. Rathinam SR, Namperumalsamy P, Nozik RA, Cunningham ET Jr. Vogt-Koyanagi-Harada syndrome after cutaneous injury. Ophthalmology. Mar 1999;106(3):635-8. [Medline].

  114. Rathinam SR, Vijayalakshmi P, Namperumalsamy P, Nozik RA, Cunningham ET Jr. Vogt-Koyanagi-Harada syndrome in children. Ocul Immunol Inflamm. Sep 1998;6(3):155-61. [Medline].

  115. Rathod DJ, Shuttleworth GN. Anterior uveitis, poliosis, and skin hypopigmentation associated with topical chloramphenicol allergy following ptosis surgery. Ophthal Plast Reconstr Surg. Jul-Aug 2007;23(4):318-9. [Medline].

  116. Ravikumar BC, Balachandran C, Sabita L, Acharya S. Vogt-Koyanagi-Harada syndrome: the useful role of punch grafting. Int J Dermatol. Jun 2000;39(6):460-2. [Medline].

  117. Ray R, Foroozan R. Uveo-meningeal syndromes. Int Ophthalmol Clin. Fall 2007;47(4):131-49, x. [Medline].

  118. Read RW, Rao NA, Cunningham ET. Vogt-Koyanagi-Harada disease. Curr Opin Ophthalmol. Dec 2000;11(6):437-42. [Medline].

  119. Read RW, Yu F, Accorinti M, et al. Evaluation of the effect on outcomes of the route of administration of corticosteroids in acute Vogt-Koyanagi-Harada disease. Am J Ophthalmol. Jul 2006;142(1):119-24. [Medline].

  120. Rubsamen PE, Gass JD. Vogt-Koyanagi-Harada syndrome. Clinical course, therapy, and long-term visual outcome. Arch Ophthalmol. May 1991;109(5):682-7. [Medline].

  121. Saari JM, Nummelin K. Iris atrophy, serous detachment of the ciliary body, and ocular hypotony in chronic phase of Vogt-Koyanagi-Harada disease. Eur J Ophthalmol. Mar-Apr 2005;15(2):277-83. [Medline].

  122. Sachdev N, Gupta V, Gupta A, Singh R. Posterior segment recurrences in Vogt-Koyanagi-Harada disease. Int Ophthalmol. Oct 2008;28(5):339-45. [Medline].

  123. Sakuta T, Morita Y, Sakai J, et al. A case of Vogt-Koyanagi-Harada disease that developed relapsing polychondritis. Mod Rheumatol. 2005;15(3):204-6. [Medline].

  124. Sheu SJ. Update on uveomeningoencephalitides. Curr Opin Neurol. Jun 2005;18(3):323-9. [Medline].

  125. Sheu SJ, Kou HK, Chen JF. Significant prognostic factors for Vogt-Koyanagi-Harada disease in the early stage. Kaohsiung J Med Sci. Mar 2004;20(3):97-105. [Medline].

  126. Sil A, Chatrath P, Gatland DJ. Deafness in Vogt-Koyanagi-Harada syndrome. J Laryngol Otol. May 2006;120(5):416-8. [Medline].

  127. Snyder DA, Tessler HH. Vogt-Koyanagi-Harada syndrome. Am J Ophthalmol. Jul 1980;90(1):69-75. [Medline].

  128. Soheilian M, Aletaha M, Yazdani S, Dehghan MH, Peyman GA. Management of pediatric Vogt-Koyanagi- Harada (VKH)-associated panuveitis. Ocul Immunol Inflamm. Apr 2006;14(2):91-8. [Medline].

  129. Sugita S, Takase H, Kawaguchi T, Taguchi C, Mochizuki M. Cross-reaction between tyrosinase peptides and cytomegalovirus antigen by T cells from patients with Vogt-Koyanagi-Harada disease. Int Ophthalmol. Apr-Jun 2007;27(2-3):87-95. [Medline].

  130. Sugita S, Takase H, Taguchi C, et al. Ocular infiltrating CD4+ T cells from patients with Vogt-Koyanagi-Harada disease recognize human melanocyte antigens. Invest Ophthalmol Vis Sci. Jun 2006;47(6):2547-54. [Medline].

  131. Swiech-Zubilewicz A, Wróblewska E, Mankowska A. [The Vogt-Koyanagi-Harada syndrome in 11-year-old girl]. Klin Oczna. 2005;107(7-9):511-4. [Medline].

  132. Sylvestre DL, Disston AR, Bui DP. Vogt-Koyanagi-Harada disease associated with interferon alpha-2b/ribavirin combination therapy. J Viral Hepat. Nov 2003;10(6):467-70. [Medline].

  133. Tabbara KF, Chavis PS, Freeman WR. Vogt-Koyanagi-Harada syndrome in children compared to adults. Acta Ophthalmol Scand. Dec 1998;76(6):723-6. [Medline].

  134. Touitou V, Bodaghi B, Cassoux N, et al. Vogt-Koyanagi-Harada disease in patients with chronic hepatitis C. Am J Ophthalmol. Nov 2005;140(5):949-52. [Medline].

  135. Touitou V, Sene D, Fardeau C, et al. Interferon-alpha2a and Vogt-Koyanagi-Harada disease: a double-edged sword?. Int Ophthalmol. Apr-Jun 2007;27(2-3):211-5. [Medline].

  136. Tsai JH, Evans M, Rao NA. Comparative study of two sets of criteria for the diagnosis of Vogt-Koyanagi-Harada disease. Am J Ophthalmol. Apr 2006;141(4):778-9; author reply 779. [Medline].

  137. Tsujikawa A, Yamashiro K, Yamamoto K, Nonaka A, Fujihara M, Kurimoto Y. Retinal cystoid spaces in acute Vogt-Koyanagi-Harada syndrome. Am J Ophthalmol. Apr 2005;139(4):670-7. [Medline].

  138. Tsuruta D, Hamada T, Teramae H, Mito H, Ishii M. Inflammatory vitiligo in Vogt-Koyanagi-Harada disease. J Am Acad Dermatol. Jan 2001;44(1):129-31. [Medline].

  139. Tugal-Tutkun I, Ozyazgan Y, Akova YA, et al. The spectrum of Vogt-Koyanagi-Harada disease in Turkey: VKH in Turkey. Int Ophthalmol. Apr-Jun 2007;27(2-3):117-23. [Medline].

  140. Vaphiades MS, Read RW. Magnetic resonance imaging of choroidal inflammation in Vogt-Koyanagi-Harada disease. J Neuroophthalmol. Dec 2004;24(4):295-6. [Medline].

  141. Weber SW, Kazdan JJ. The Vogt--Koyanagi--Harada syndrome in children. J Pediatr Ophthalmol. Mar-Apr 1977;14(2):96-9. [Medline].

  142. Yamaguchi Y, Otani T, Kishi S. Tomographic features of serous retinal detachment with multilobular dye pooling in acute Vogt-Koyanagi-Harada disease. Am J Ophthalmol. Aug 2007;144(2):260-5. [Medline].

  143. Yamaki K, Gocho K, Hayakawa K, Kondo I, Sakuragi S. Tyrosinase family proteins are antigens specific to Vogt-Koyanagi-Harada disease. J Immunol. Dec 15 2000;165(12):7323-9. [Medline].

  144. Yamaki K, Hara K, Sakuragi S. Application of revised diagnostic criteria for vogt-koyanagi-harada disease in Japanese patients. Jpn J Ophthalmol. Mar-Apr 2005;49(2):143-8. [Medline].

  145. Yamaki K, Ohono S. Animal models of Vogt-Koyanagi-Harada disease (sympathetic ophthalmia). Ophthalmic Res. 2008;40(3-4):129-35. [Medline].

  146. Yamamoto Y, Fukushima A, Nishino K, Koura Y, Komatsu T, Ueno H. Vogt-koyanagi-harada disease with onset in elderly patients aged 68 to 89 years. Jpn J Ophthalmol. Jan-Feb 2007;51(1):60-3. [Medline].

  147. Yanagihara S, Mizuno N, Naruse A, Tateishi C, Tsuruta D, Ishii M. Linear immunoglobulin A/immunoglobulin G bullous dermatosis associated with Vogt-Koyanagi-Harada disease. J Dermatol. Aug 2011;38(8):798-801. [Medline].

  148. Yang P, Fang W, Wang L, Wen F, Wu W, Kijlstra A. Study of macular function by multifocal electroretinography in patients with Vogt-Koyanagi-Harada syndrome. Am J Ophthalmol. Nov 2008;146(5):767-71. [Medline].

  149. Yang P, Ren Y, Li B, Fang W, Meng Q, Kijlstra A. Clinical characteristics of Vogt-Koyanagi-Harada syndrome in Chinese patients. Ophthalmology. Mar 2007;114(3):606-14. [Medline].

  150. Yokota K, Shimizu H. Psoriasis vulgaris associated with Vogt-Koyanagi-Harada syndrome. Clin Exp Dermatol. May 2001;26(3):308-9. [Medline].

  151. Zalts R, Hayek T, Baruch Y, Nakhoul F, Miller B. Vogt-Koyanagi-Harada syndrome associated with renal failure: a case report. J Nephrol. Mar-Apr 2006;19(2):225-8. [Medline].

 
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