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

Abstract

ABSTRACT.Purpose: Vogt-Koyanagi-Harada (VKH) syndrome is usually treated with highdose systemic corticosteroids. However, in a pregnant patient with VKH syndrome, the effects of high-dose corticosteroids on the fetus are controversial. We discuss treating VKH syndrome during pregnancy, systemic corticosteroids, and abnormalities in the delivered infant. Methods: Case report and literature review. Results: A 26-year-old Japanese woman in the 16 th week of gestation was diagnosed with VKH syndrome and treated with high-dose systemic prednisolone after the 18 th week of gestation. Although the patient's ocular findings gradually improved, a low-birth-weight infant was delivered with epibulbar dermoid, lipodermoids, and preauricular appendages. Although low birth weight might result from systemic prednisolone administration, the anomalies of the infant may have been inherited rather than caused by VKH syndrome and high-dose systemic corticosteroid administration. Conclusion: In this case and previously reported cases, VKH syndrome and systemic corticosteroids administered during pregnancy may not precipitate abortion and congenital malformation.

Treatment of severe non-infectious uveitis in high-risk conditions (Part I): pregnancy and malignancies, management and safety issues

“…There are no reported side effects in other similar case reports published by Doi et al [40] and Miyata et al [41].…”

Early resolution of subretinal fluid without high-dose corticosteroids in a pregnant patient with Vogt-Koyanagi-Harada disease: a case report

“…In another report, Steahly detailed the adverse effects of high-dose corticosteroid treatment for VKH disease during pregnancy in two cases: one patient suffered a spontaneous abortion, and the other delivered a premature infant [ 5 ]. Doi et al also reported that a pregnant VKH patient treated with a high-dose systemic corticosteroid delivered a low-birth-weight infant with an epibulbar dermoid, lipodermoids, and preauricular appendages, although the relationship among VKH disease, systemic corticosteroids, spontaneous abortion, and congenital malformation was not clear [ 6 ]. Østensen and Skomsvoll stated that, administered during early pregnancy, corticosteroids are also considered a risk factor for the development of oral clefts [ 12 ].…”

Two cases of Vogt–Koyanagi–Harada’s disease in sub-Saharan Africa

“…In a study, the use of systemic steroids in midtrimester did not cause any abnormalities in the baby 7. In another study, high-dose systemic steroids produced low birth weight in the baby 8. The other systemic effects noted in the baby were reported to be unconnected to the steroids.…”