Gómez-Piña Juan José, Vázquez-Hernández Adriana Elizabeth, Flores-Flores Nayeli, Cortés-Luis Marco Antonio, Olvera-Acevedo Arturo
Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital de Especialidades "Dr. Antonio Fraga Mouret", Servicio de Medicina Interna. Ciudad de México, México.
Instituto Mexicano del Seguro Social, Centro Médico Nacional La Raza, Hospital General "Dr. Gaudencio González Garza", Servicio de Oftalmología. Ciudad de México, México.
Rev Med Inst Mex Seguro Soc. 2023 Sep 4;61(5):702-706. doi: 10.5281/zenodo.8316491.
Vogt-Koyanagi-Harada syndrome (VKH) is a systemic disease that affects organs profuse in melanocytes, presenting with a chronic and diffuse bilateral granulomatous panuveitis, as well as neurological, auditory, and cutaneous manifestations. In this article, a systematic approach is presented for the diagnostic management of VKH syndrome, considering relevant diagnostic possibilities to rule out other entities that manifest similar symptoms.
71-year-old man with a long-standing history of vitiligo, who experienced visual loss in his right eye 6 months before his admission, along with bilateral hearing loss predominantly in the right ear. During his hospitalization, he presented with chronic headache, fever, and significant involuntary weight loss. Ophthalmological examination revealed that his right eye only perceived light and had hyperemic bulbar conjunctiva, while the left eye had a visual acuity of 20/200. The right fundus had scattered pigmentation, while the left had an edematous optic disc and right optic atrophy.
The diagnosis of VKH syndrome is established by the presence of the 5 diagnostic criteria for complete disease, including retinal depigmentation, neurological alterations, and dermatological manifestations. Since patients can present with a wide variety of symptoms, initial differential diagnosis should be considered, which represents a diagnostic challenge.
伏格特-小柳-原田综合征（VKH）是一种累及富含黑素细胞器官的全身性疾病，表现为慢性、双侧弥漫性肉芽肿性全葡萄膜炎，以及神经、听觉和皮肤表现。本文介绍了一种VKH综合征诊断管理的系统方法，考虑了相关诊断可能性以排除表现出类似症状的其他疾病。
一名71岁男性，有长期白癜风病史，入院前6个月右眼视力丧失，同时伴有以右耳为主的双侧听力丧失。住院期间，他出现慢性头痛、发热和明显的非自愿体重减轻。眼科检查发现，他的右眼仅能感知光线，球结膜充血，而左眼视力为20/200。右眼眼底有散在色素沉着，而左眼视盘水肿，右眼视神经萎缩。
VKH综合征的诊断依据完整疾病的5项诊断标准，包括视网膜色素脱失、神经改变和皮肤表现。由于患者可能出现各种各样的症状，应考虑进行初步鉴别诊断，这是一项诊断挑战。
