A V Pradeep, Kumar J S Arun, K N Naveen, Rao Sonali, Shetty Sharan
Assistant Professor, Department of Ophthalmology, Sri Dharmasthala Manjunatheshwara College of Medical Sciences & Hospital Sattur, Dharwad Karnataka, India .
Professor, Department of ENT, Sri Dharmasthala Manjunatheshwara College of Medical Sciences & Hospital Sattur, Dharwad Karnataka, India .
J Clin Diagn Res. 2014 Apr;8(4):VD06-VD07. doi: 10.7860/JCDR/2014/8067.4303. Epub 2014 Apr 15.
Vogt-Koyanagi-Harada syndrome (VKH) is a bilateral intraocular granulomatous panuveitis which is frequently associated with systemic manifestations such as meningismus, tinnitus, poliosis and vitiligo of autoimmune aetiology. Headache by itself, does not fulfill the diagnostic criteria and is insufficient for the diagnosis. A 22-year-old male presented with a 10 day history of headache, followed by decreased vision in both eyes. Slit lamp biomicroscopy revealed sluggishly reactive pupils with anterior uveitis, mild vitritis and hyperaemic discs with bilateral exudative retinal detachments. All uveitis workups were negative. Follow up of three years revealed no neurological or auditory symptoms. Headache alone, followed by decreased vision, before the onset of neurological and auditory symptoms, can be an initial presentation of Vogt-Koyanagi-Harada (VKH) syndrome. VKH should be considered in the differential diagnosis of atypical presentations of headache.
伏格特-小柳-原田综合征(VKH)是一种双侧眼内肉芽肿性全葡萄膜炎,常伴有如颈项强直、耳鸣、白发和白癜风等自身免疫病因的全身表现。单纯头痛不符合诊断标准,不足以确诊。一名22岁男性,有10天头痛病史,随后双眼视力下降。裂隙灯生物显微镜检查显示瞳孔反应迟缓伴前葡萄膜炎、轻度玻璃体炎、视盘充血,双侧渗出性视网膜脱离。所有葡萄膜炎相关检查均为阴性。三年随访未发现神经或听觉症状。在神经和听觉症状出现之前,先有头痛,随后视力下降,单独出现这种情况可能是伏格特-小柳-原田(VKH)综合征的初始表现。在头痛非典型表现的鉴别诊断中应考虑VKH综合征。