Vogt-Koyanagi-Harada Disease, a Rare Entity in Spain: The Challenge of Worldwide Immigration and Globalization

Eur J Case Rep Intern Med. 2018 Jul 26;5(7):000886. doi: 10.12890/2018_000886. eCollection 2018.

Abstract

Vogt-Koyanagi-Harada disease is rare, mediated by autoimmune melanocyte inflammation and facilitated by genetic predisposition[1-3]. The main clinical features include uveitis, meningitis, tinnitus and sensorineural deafness, and skin and hair depigmentation. It usually develops in four consecutive stages: prodromal, acute uveitic, convalescent, and chronic or recurrent[4]. In view of the first two stages, the differential diagnosis takes into account uveo-meningeal syndromes. Treatment is based on high dose corticosteroids. We present the case of a 14-year-old girl admitted to hospital with fever, progressive uveo-meningeal symptoms, and sensorineural hearing loss. After work-up, the final diagnosis of Vogt-Koyanagi-Harada disease was made.

Learning points: Vogt-Koyanagi-Harada disease should be considered when a patient presents with uveo-meningeal syndromes, particularly in pigmented ethnic groups.Acute bilateral uveitis should raise suspicion of Vogt-Koyanagi-Harada disease.Early stage diagnosis leads to prompt appropriate treatment and improves patient outcomes.

Keywords: Koyanagi–Harada disease; Vogt; aseptic meningitis; uveo-meningeal syndromes.