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

Abstract

A 28 year old pregnant woman with Vogt-Koyanagi syndrome is reported. Despite the use of steroid therapy, she became blind. She delivered a boy Apgar 8. The newborn developed a meningoencephalitis in the nursery and died two years later with evidence of cerebral palsy. Correlation between both mother and son disease has not been found.

Vogt‐Koyanagi‐Harada syndrome in a pregnant patient treated with high‐dose systemic corticosteroids

“…Friedman et al (1980) reported that 2 pregnant woman (5 and 7 months' gestation) with VKH syndrome were successfully treated with systemic corticosteroids and delivered healthy babies. Wittig et al (1983) reported that an infant delivered by a patient with VKH syndrome who was treated with systemic corticosteroids had meningoencephalitis, although they did not find a disease correlation between the patient and the infant. Steahly (1990) reported that highdose prednisolone was administered to 2 patients with VKH syndrome from about 2 months before pregnancy.…”

“…To the best of our knowledge, 10 cases of VKH syndrome during pregnancy have been reported (Friedman et al 1980;Nohara et al 1995;Satoh et al 1986;Snyder & Tessler 1980;Steahly 1990;Wittig et al 1983). Pregnancy likely has a beneficial effect on the VKH syndrome because of placental production of steroid hormone and cellular and humoral immunity depression (Moore & Persaud 1993a;Nohara et al 1995;Satoh et al 1986;Snyder & Tessler 1980;Steahly 1990).…”

“…Therefore, when VKH syndrome is diagnosed in pregnant patients, the natural course of the disease should be observed. Spontaneous resolution has not occurred in all cases of VKH syndrome during pregnancy, and systemic corticosteroids have been administered in some cases (Friedman et al 1980;Snyder & Tessler 1980;Steahly 1990;Wittig et al 1983), which usually results in improved symptoms, with the exception of one case reported by Wittig et al (1983). However, when systemic corticosteroids are terminated before delivery, the symptoms of VKH syndrome sometimes recur after delivery (Snyder & Tessler 1980), probably because placental production of steroid hormone and cellular and humoral immunity depression stopped upon termination of the pregnancy (Snyder & Tessler 1980).…”