Vogt–Koyanagi–Harada disease in Hispanic patients

Sukavatcharin, Somsiri; Tsai, Julie H.; Rao, Narsing A.

doi:10.1007/s10792-006-9017-6

Cited by 55 publications

(35 citation statements)

References 20 publications

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“…On the other hand, neurological signs and dysacousia are quite common (74-76%) among Japanese patients [23,28], while intertegumentary signs are more often seen in Chinese patients (39-41%) [29]. When looking at ocular manifestations, studies conducted on South American patients are concordant in rating a optic disc swelling occurrence significantly lower than in Asian patients (8,6% -9% versus 50-73%, respectively) [26][27][28][29][30] Giordano et al) [26,30]. Response to therapy and complication rates are reported to be similar among ethnic groups [26].…”

Section: Discussionmentioning

confidence: 99%

“…Ethnic groups do not only differ with respect to incidence and prevalence of the disease, but also for the frequency of clinical manifestations: Hispanic patients often present without extraocular symptoms in early phases of the disease [26], as we observed in this case, and they have globally lower rates of intertegumentary signs (between 11 and 16%) and hearing impairment (9%) compared to Asian patients [27]. On the other hand, neurological signs and dysacousia are quite common (74-76%) among Japanese patients [23,28], while intertegumentary signs are more often seen in Chinese patients (39-41%) [29].…”

Section: Discussionmentioning

confidence: 99%

“…When looking at ocular manifestations, studies conducted on South American patients are concordant in rating a optic disc swelling occurrence significantly lower than in Asian patients (8,6% -9% versus 50-73%, respectively) [26][27][28][29][30] Giordano et al) [26,30]. Response to therapy and complication rates are reported to be similar among ethnic groups [26].…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Differentiating Vogt-Koyanagi-Harada syndrome from recurrent optic neuritis: a case report and review of the literature concerning Hispanic patients

Scarioni

Pietroboni

Invernizzi

et al. 2017

Mult Scler Demyelinating Disord

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Background: First recognized at the beginning of twentieth century and named after three authors who independently described some affected patients, Vogt-Koyanagi-Harada syndrome is a rare multisystemic autoimmune disease targeting melanin-containing tissues of the eye, meninges, inner ear and skin. It predominantly affects Asian people, but also people with darker skin pigmentation such as Native Americans and Hispanics (Mestizos), whose ancestors moved from Asia across the Bering strait to North America and further down to Central and South America. Heterogenous presentation is observed, especially among different ethnic groups. Here we describe the case of an Hispanic South American patient presenting with multiple visual relapses and thus mimicking recurrent optic neuritis; we provide insights into the differential diagnosis and a brief review of the literature concerning the epidemiology of Vogt-Koyanagi-Harada syndrome in Hispanic patients compared with other ethnic groups. Case presentation: A 34-year-old Ecuadorian woman presented over years with multiple relapses involving the visual system. She was investigated in both neurologic and ophthalmic clinical settings. Brain Magnetic Resonance Imaging, cerebrospinal fluid examination, Spectral Domain Optical Coherence Tomography and Fluorescein Angiography were performed. She was misdiagnosed first as an optic neuritis pointing to a demyelinating disorder, then as a posterior scleritis. Due to the protean manifestations of Vogt-Koyanagi-Harada syndrome and the incomplete clinical presentation at the beginning, the right diagnosis was made only at a later disease stage using retrospective criteria. Conclusions: Hispanic patients often present without extraocular symptoms in early phases of the disease and they have globally lower rates of intertegumentary signs compared to Asian patients. The diagnosis of a multisystemic disease such as Vogt-Koyanagi-Harada syndrome is a challenge involving specialists operating in different medical fields; especially in urban multiethnic populations, rare etiologies of common symptoms have to be taken into account when performing a differential diagnosis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Differentiating Vogt-Koyanagi-Harada syndrome from recurrent optic neuritis: a case report and review of the literature concerning Hispanic patients

Scarioni

Pietroboni

Invernizzi

et al. 2017

Mult Scler Demyelinating Disord

View full text Add to dashboard Cite

show abstract

“…It typically presents in the form of localized or multifocal inflammatory ERD involving the posterior fundus, but may evolve into extensive near total or total bullous retinal detachment [3,[6][7][8][9][10]. OCT nicely shows the subretinal fluid already evidenced by fundus examination, and the presence of typical fibrinous septa dividing the subretinal space into several compartments often characterize acute VKH disease [2,3,6,11].…”

Section: Discussionmentioning

confidence: 99%

Clinical and multimodal imaging characteristics of acute Vogt–Koyanagi–Harada disease unassociated with clinically evident exudative retinal detachment

et al. 2015

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The purpose of this study was to describe the clinical and multimodal imaging findings in acute Vogt-Koyanagi-Harada (VKH) disease without clinically evident exudative retinal detachment (ERD). We retrospectively reviewed the charts of 18 patients (36 eyes), diagnosed with acute VKH disease without clinically evident ERD. All patients underwent complete ophthalmic examination, fundus photography, optical coherence tomography (OCT), B-scan ultrasonography, fluorescein angiography (FA), and indocyanine green angiography (ICGA). Of 18 patients, twelve (66.7 %) were female and 6 (33.3 %) were male. Mean age was 39 years (range, 23-60). Ten patients had been referred with an erroneous diagnosis of primary optic nerve disorder (8; 44.4 %) or isolated anterior uveitis (2; 11.1 %). Anterior chamber or vitreous inflammatory reaction was noted in 22 eyes (61.1 %), each. Fundus findings included optic disc swelling in 30 eyes (83.3 %), retinal striae in 20 eyes (55.5 %), and yellowish deep lesions in 3 eyes (8.3 %). OCT showed a shallow, localized subclinical ERD in 18 eyes (50 %), and retinal pigment epithelial folds in 23 eyes (63.9 %). B-scan ultrasonography showed diffuse, low- to medium-reflective choroidal thickening in all eyes. FA disclosed delayed choroidal perfusion in at least one eye of all patients (100 %), mild pinpoint leakage in 21 eyes (58.3 %), optic disc hyperfluorescence in 35 eyes (97.2 %) and choroidal folds in 13 eyes (36.1 %). ICGA findings included delayed choroidal perfusion in 24 eyes (66.7 %), decrease in the number of large choroidal vessels in 36 eyes (100 %), fuzzy choroidal vessels in 35 eyes (97.2 %), and hypofluorescent dark dots in 28 eyes (77.8 %). The association of bilateral optic disc edema with retinal striae and intraocular inflammatory reaction highly suggests acute VKH disease. A multimodal imaging approach including fundus photography, OCT, B-scan ultrasonography, FA, and ICGA provides important clues for the definite diagnosis and help differentiate VKH disease from primary optic nerve disorders.

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“…Genetic factors play an important role in VKH, as demonstrated by a higher rate of this syndrome in populations, such as Japanese [3], Chinese [4] and Amerindians [5], as well as in admixed groups, especially Hispanics, [1,6], Asian Indians [7,8], and individuals of Middle Eastern heritage who have Asian and Amerindian ancestors. It is uncommon in Caucasians and individuals of black ethnicity [7].…”

Section: Introductionmentioning

confidence: 99%

Major histocompatibility complex and strong human leukocyte antigen–DRB1 and gender association with Vogt–Koyanagi–Harada syndrome in Mexican Mestizos

et al. 2011

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Vogt–Koyanagi–Harada disease in Hispanic patients

Abstract: Hispanic patients with VKH often present without extraocular changes during early phase of the disease. However, once the disease evolves into the chronic phase, integumentary system involvement may become apparent in some patients.

Cited by 55 publications

References 20 publications

Differentiating Vogt-Koyanagi-Harada syndrome from recurrent optic neuritis: a case report and review of the literature concerning Hispanic patients

Differentiating Vogt-Koyanagi-Harada syndrome from recurrent optic neuritis: a case report and review of the literature concerning Hispanic patients

Clinical and multimodal imaging characteristics of acute Vogt–Koyanagi–Harada disease unassociated with clinically evident exudative retinal detachment

Major histocompatibility complex and strong human leukocyte antigen–DRB1 and gender association with Vogt–Koyanagi–Harada syndrome in Mexican Mestizos

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