Alezzandrini Syndrome Treatment & Management

Updated: Apr 20, 2020
  • Author: Camila K Janniger, MD; Chief Editor: William D James, MD  more...
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Treatment

Medical Care

Medical care includes follow-up fundus examinations, visual acuity tests, and audiometry.

In cases with widespread depigmentation, treatment with psoralen plus ultraviolet A (PUVA) can be provided. However, PUVA should be used with great caution in patients with anterior uveitis because phototherapy might aggravate the ocular inflammatory disorder. As for uveitis in this syndrome, interleukin 6 therapy may be an option. [31]

Topical steroids may be tried on localized areas of vitiligo. Patients with vitiligo should use sunscreen to prevent sunburn and subsequent skin cancer. See Vitiligo for more information about medical treatment. Intravitreal bevacizumab injection has been reported. [32]

Limited experience suggests that infliximab as adjunctive therapy may be of benefit in reducing systemic corticosteroid dosage, at least in those with Vogt-Koyanagi-Harada syndrome. [33] A study comparing cyclosporine/mycophenolate mofetil and cyclosporine/azathioprine in Vogt-Koyanagi-Harada patients delineated no statistically significant difference in efficacy or safety. [34, 35] When untreated from early stages, severe iris depigmentation and ocular hypotony may develop. [36]

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Consultations

Consultation with the following specialists may be needed:

  • Dermatologist

  • Ophthalmologist

  • Otolaryngologist

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Complications

A gradual loss of vision may occur. Deafness may occur. Retinal detachment is a possible complication. Patients with diabetes mellitus should be closely monitored because they have an increased risk of retinal detachment, as Hoffman and Dudley observed. [13]

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Prevention

Because Alezzandrini syndrome is a rare disease of unknown etiology, no methods of prevention are yet known.

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Long-Term Monitoring

Follow-up fundus examinations, visual acuity tests, and audiometry can be performed. These examinations may aid in the early detection of complications such as deafness and retinal detachment.

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