Sindrome de Vogt-Koyanagi-Harada: relato de um caso

unclassified

Sindrome de Vogt-Koyanagi: relato de um caso em gestante

Wittig

Moreira

Basedow³

1983

Sindrome de Vogt-Koyanagi-Harada: relato de dois casos

Marchiori

Scaff

Callegaro

et al. 1981

São relatados, neste trabalho, dois casos de síndrome de Vogt-Koyanagi--Harada (VKH). OBSERVAÇÕESCaso 1 -M.A.M.M., mulher de cor parda» 40 anos de Idade, brasileira, RG. 1.087.068, internada em 24-04-1974 com queixa de cefaléia holocrariana intensa, dor ocular inicialmente à direita e hiperemia conjuntival com lacrimejamento, tudo iniciado há três meses. Após período de melhora, apresentou outro episódio doloroso, agora com diminuição da acuidade visual, inicialmente à esquerda e ulteriormente à direita. Nessa ocasião houve melhora parcial da visão porém, logo a seguir, a paciente referiu nova crise dolorosa acompanhada de dores migratórias nas grandes articulações, perda da visão e intensa dificuldade auditiva à direita. Nos antecedentes pessoais deve ser salientado asma brôhquica. Nos antecedentes hereditários e no interrogatório sobre os diversos aparelhos nada de importante há a assinalar. O exame da pele não revelou anormalidade. O exame do aparelho respiratório mostrou roncos e sibllos esparsos. O exame doe demais órgãos e aparelhos foi normal. Exame neurológico -Psiquismo integro, lingua-

Uveomeningencefalites: registro de dois casos

Sanvito¹,

Tilbery²,

Villares³

1982

The uveomeningoencephalitic syndromes are inflammatory diseases, more prevalent in oriental patients, without sexual predilection and with mean age of 30 years. From the clinical point of view they affect the uvea, retina, meninges, the central nervous system and skin and in most cases the onset is followed by three phases: the meningoencephalitic phase, the acute ophthalmic phase and the dermatologic phase. These includes the Harada disease, the Vogt-Koyanagi disease, the Behçet disease and the idiopathic forms. The Vogt-Koyanagi syndrome is a chronic and severa bilateral exudative uveitis associated with whitening of the hair and eyelashes and varying signs of meningeal irritation, less frequent than in Harada's disease. The Harada syndrome is a posterior uveitis accompanied by signs of meningeal irritation, increased protein levels and pleocytosis of the cerebrospinal fluid. The Behçet's disease is a relapsing illness, characterized by oral and genital aphtous ulcers and ocular inflammation. In many cases there are additional features; in 10 to 25 percent of the cases there are neurologic involvement, and any portion of the nervous system may be affected. The authors studied two cases of uveomeningoencephalic syndrome, one case of Vogt-Koyanagi-Harada disease (case 1) and another of Behçet disease (case 2). The case 1 was a white Brazilian forty-five year-old man, with a acute headache, mental confusion and signs of meningeal irritation. The cerebrospinal fluid was a inflammatory one, with increased lymphocytes and monocytes, the one month after the patient developed bilateral uveit. The patient complicated with amblyopia of the left eye and a Korsakoff syndrome. There was no correlation in the literature of the Korsakoff syndrome and the uveomeningoencephalitic syndrome. The case 2 was a white Brazilian, twenty-four year-old man, with two episodes of meningitis, genital recurrent aphtous ulcers and uveitis in the right eye, with latter blindness of this eye. Some considerations about the etiopathogenic aspects are done and about the controversial use of corticoids in the treatment of these syndromes.