Ghipponi J P, Boitte J P, Rosier S, Lawani R, Meyer F, Bouat C
Service d'Ophtalmologie, l'Hôpital d'Instruction des Armées Laveran, Marseille, France.
Med Trop (Mars). 1995;55(4 Pt 2):459-61.
Harada's disease is a uveo-meningitis syndrome characterized by meningo-encephalic manifestations preceded by bilateral posterior uveal lesions. The etiology of Harada's disease is still unclear but it probably involves an auto-immune reaction to melanocytes. This mechanism would account for the high incidence of Harada's disease in dark-skinned patients. This report describes a case of Harada's disease that occurred in a 28-year-old woman from North Africa. Ophthalmologic manifestations were typical with regard to clinical features and course involving bilateral papillary edema followed by exsudative detachment of the retina and diffuse cicatricial epitheliopathy of the posterior poles. However neurologic signs were mild, the main finding being atypical headache, and this particularity delayed diagnosis. Limited cerebral involvement that did not coincide with ocular lesions explains the fact that a thorough search for posterior uveal involvement with the aforesaid features was necessary. Although it occurs mainly in dark-skinned Asians, Harada's disease deserves the attention of physicians practicing in tropical areas.
原田病是一种葡萄膜脑膜炎综合征,其特征是双侧后葡萄膜病变先于脑膜脑症状出现。原田病的病因仍不明确,但可能涉及对黑素细胞的自身免疫反应。这一机制可以解释深肤色患者中原田病的高发病率。本报告描述了一例发生在一名来自北非的28岁女性身上的原田病病例。就临床特征和病程而言,眼科表现具有典型性,包括双侧乳头水肿,随后是视网膜渗出性脱离和后极部弥漫性瘢痕性上皮病变。然而,神经症状较轻,主要表现为非典型头痛,这一特殊性延误了诊断。脑部受累有限且与眼部病变不一致,这就解释了为何有必要彻底检查是否存在具有上述特征的后葡萄膜受累情况。尽管原田病主要发生在深肤色的亚洲人身上,但它值得在热带地区执业的医生关注。