Kamondi A, Szegedi A, Papp A, Seres A, Szirmai I
Department of Neurology, Faculty of Medicine, Semmelweis University of Budapest, 1083 Balassa u. 6, Budapest, Hungary.
Eur J Neurol. 2000 Nov;7(6):719-22. doi: 10.1046/j.1468-1331.2000.00156.x.
Vogt-Koyanagi-Harada (VKH) disease in a Gypsy woman was diagnosed 4 months after her initial complaints. The delay is explained by the facts that: (1) the characteristic ophthalmological symptoms, which usually herald the disease and ensure early diagnosis, developed only late during the course; and (2) only retrospective analysis of the cerebrospinal fluid (CSF) cell preparation proved the presence of melanin-laden macrophages (MLMs), specific for the syndrome. We emphasize that VKH syndrome may initially present as aseptic meningitis, without specific ophthalmological symptoms. In suspected cases a very detailed CSF cell analysis is needed, because the presence of MLMs could confirm the diagnosis. However, VKH syndrome has a much higher incidence in Asia; cases in other races, including white people in Europe, also occur.
一名吉普赛女性在首次出现症状4个月后被诊断为Vogt-小柳-原田（VKH）病。延迟诊断的原因如下：（1）通常预示该病并确保早期诊断的典型眼科症状在病程后期才出现；（2）仅通过对脑脊液（CSF）细胞涂片进行回顾性分析才证实存在该综合征特有的载黑素巨噬细胞（MLM）。我们强调，VKH综合征最初可能表现为无菌性脑膜炎，而无特定的眼科症状。在疑似病例中，需要进行非常详细的脑脊液细胞分析，因为MLM的存在可确诊。然而，VKH综合征在亚洲的发病率要高得多；其他种族也有病例发生，包括欧洲的白人。
