Vogt-Koyanagi-Harada Syndrome

Abstract

Although the prognosis for VKH syndrome was greatly improved, future prospective, controlled, multi-center studies are needed to determine the optimal treatment regime for this disease. The IL17/23 pathway may provide a novel therapeutic target to control inflammation in VKH syndrome.

Clinical trial: cyclophosphamide pulse therapy – a promising therapeutic alternative in refractory Crohn’s disease

“…Duration of response after cyclophosphamide in these patients lasted a median 10 months (range [4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. In this group, three patients had achieved remission and one patient had experienced a response to the cyclophosphamide pulse therapy.…”

“…[9][10][11] Recent data demonstrated efficacy of cyclophosphamide in the Vogt-Koyanagi-Harada Syndrome. 12 This granulomatous uveitis is critically driven by the IL17 ⁄ 23 pathway, a characteristic feature of CD. The immunosuppressive mechanisms of cyclophosphamide are only partially elucidated and mainly attributed to the cytotoxic action of its metabolite chloracetaldehyde.…”

Vogt-Koyanagi-Harada Disease

“…The precise pathogenesis remains unidentified in the vast majority of patients, however. [1][2][3][4][5][6] While corticosteroids are the mainstay of therapy and are required to control active inflammation during episodes of acute or recurrent inflammation, cumulative evidence supports the first-line use of corticosteroid-sparing immunosuppressive agents to reduce the risk of recurrence, decrease the development of late complications, and improve long-term vision. [16][17][18][19][20] Multimodal imaging studies, particularly fluorescein angiography and spectral domain-ocular coherence tomography (SD-OCT), are important adjuncts for initial diagnosis and early monitoring of treatment response.…”

“…[1][2][3][4][5][6] Four stages of VKH disease are recognized, including prodromal, acute uveitic, convalescent, and chronic/recurrent uveitic. A history of penetrating ocular trauma or surgery prior to the onset of uveitis precludes the diagnosis.…”

Vogt-Koyanagi-Harada Disease, Diabetes Mellitus, and Psoriasis in a Child

“…7 An underlying T-cell-mediated autoimmune process directed against melanocytes has been postulated as the likely immunologic mechanism, with infectious agents as possible triggers in genetically susceptible individuals. 7 IDDM is also an autoimmune disorder characterized by lymphocyte-mediated destruction of insulin-producing β cells in the pancreatic islets of Langerhans. Genetic and environmental factors, including infections, are also described in the pathogenesis of IDDM.…”