1
|
Gentile P, Ragusa E, Bolletta E, De Simone L, Gozzi F, Cappella M, Fastiggi M, De Fanti A, Cimino L. Epidemiology of Pediatric Uveitis. Ocul Immunol Inflamm 2023; 31:2050-2059. [PMID: 37922466 DOI: 10.1080/09273948.2023.2271988] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/12/2023] [Indexed: 11/05/2023]
Abstract
Uveitis is uncommon in children and its diagnosis and treatment are challenging. Little is known of the epidemiology of pediatric uveitis. Indeed, population-based studies in the literature are rare. However, there are many tertiary referral center reports that describe the patterns of uveitis in childhood, although few are from developed countries, and their comparison presents some issues. Anterior uveitis is the most frequent entity worldwide, especially in Western countries, where juvenile idiopathic arthritis is diffuse. Most cases of intermediate uveitis do not show any association with infectious or noninfectious systemic diseases. In low- and middle-income countries, posterior uveitis and panuveitis are prevalent due to the higher rates of infectious etiologies and systemic diseases such as Behçet disease and Vogt-Koyanagi-Harada disease. In recent decades, idiopathic uveitis rate has decreased thanks to diagnostic improvements.
Collapse
Affiliation(s)
- P Gentile
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
- Ocular Immunology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - E Ragusa
- Institute of Ophthalmology, University of Modena and Reggio Emilia, Modena, Italy
| | - E Bolletta
- Ocular Immunology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - L De Simone
- Ocular Immunology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - F Gozzi
- Ocular Immunology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - M Cappella
- Pediatric Rheumatology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - M Fastiggi
- Pediatric Rheumatology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - A De Fanti
- Pediatrics Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - L Cimino
- Ocular Immunology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, with Interest in Transplants, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, Modena, Italy
| |
Collapse
|
2
|
Eatz T, Charles JH. Vogt-Koyanagi-Harada syndrome in the setting of COVID-19 infection. Clin Case Rep 2023; 11:e6617. [PMID: 36950665 PMCID: PMC10025255 DOI: 10.1002/ccr3.6617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 10/26/2022] [Accepted: 11/04/2022] [Indexed: 03/24/2023] Open
Abstract
To report a case of Vogt-Koyanagi-Harada disease (VKH) in a 27-year-old male 2 weeks proceeding COVID-19 infection onset. Severe complications of VKH can be avoided by early diagnosis and adequate treatment with corticosteroids and immunosuppressants. It is possible that COVID-19 was a potential immunological trigger of VKH in our patient.
Collapse
Affiliation(s)
- Tiffany Eatz
- Department of Neurology, Miller School of MedicineThe University of MiamiMiamiFloridaUSA
| | - Jude Hassan Charles
- Department of Neurology, Miller School of MedicineThe University of MiamiMiamiFloridaUSA
| |
Collapse
|
3
|
Lueck CJ. Vogt-Koyanagi-Harada syndrome: what neurologists need to know. Pract Neurol 2019; 19:278-281. [PMID: 30890585 DOI: 10.1136/practneurol-2018-002165] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Accepted: 02/08/2019] [Indexed: 11/03/2022]
Affiliation(s)
- Christian J Lueck
- Neurology, The Canberra Hospital, Canberra, Australian Capital Territory, Australia
- Australian National University Medical School, Canberra, Australian Capital Territory, Australia
| |
Collapse
|
4
|
Vogt-Koyanagi-Harada disease. Surv Ophthalmol 2017; 62:1-25. [DOI: 10.1016/j.survophthal.2016.05.002] [Citation(s) in RCA: 123] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 05/16/2016] [Accepted: 05/16/2016] [Indexed: 12/17/2022]
|
5
|
Baltmr A, Lightman S, Tomkins-Netzer O. Vogt-Koyanagi-Harada syndrome - current perspectives. Clin Ophthalmol 2016; 10:2345-2361. [PMID: 27932857 PMCID: PMC5135404 DOI: 10.2147/opth.s94866] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Vogt–Koyanagi–Harada syndrome is a cause of noninfectious panuveitis, leading to significant vision loss in many patients. It is an autoimmune disease occurring in genetically susceptible individuals and clinically presents as bilateral panuveitis with serous retinal detachments and hyperemic, swollen optic discs, which are associated with neurological and auditory manifestations. Early diagnosis and prompt and adequate treatment with immunosuppressive agents (corticosteroids and other immunosuppressive drugs) may halt disease progression and prevent recurrences and vision loss. This review summarizes the current knowledge on the variable clinical aspects of this disease, highlighting diagnostic and treatment strategies.
Collapse
Affiliation(s)
- Abeir Baltmr
- Uveitis Service, Moorfields Eye Hospital, London, UK
| | - Sue Lightman
- Uveitis Service, Moorfields Eye Hospital, London, UK; Department of Clinical Ophthalmology, UCL Institute of Ophthalmology, London, UK
| | - Oren Tomkins-Netzer
- Uveitis Service, Moorfields Eye Hospital, London, UK; Department of Clinical Ophthalmology, UCL Institute of Ophthalmology, London, UK; Faculty of Medicine, Technion, Israel Institute of Technology, Haifa, Israel
| |
Collapse
|
6
|
Silpa-archa S, Silpa-archa N, Preble JM, Foster CS. Vogt–Koyanagi–Harada syndrome: Perspectives for immunogenetics, multimodal imaging, and therapeutic options. Autoimmun Rev 2016; 15:809-19. [DOI: 10.1016/j.autrev.2016.04.001] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Accepted: 03/24/2016] [Indexed: 11/24/2022]
|
7
|
Attia S, Khochtali S, Kahloun R, Zaouali S, Khairallah M. Vogt–Koyanagi–Harada disease. EXPERT REVIEW OF OPHTHALMOLOGY 2014. [DOI: 10.1586/eop.12.63] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
8
|
|
9
|
Smit J, Berman DC, Nielsen H. Vogt–Koyanagi–Harada syndrome: A rare but important differential diagnosis of viral meningitis. ACTA ACUST UNITED AC 2011; 44:157-9. [DOI: 10.3109/00365548.2011.611171] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
10
|
Hooper C, Pavesio C. Investigations in the diagnosis of uveitis. EXPERT REVIEW OF OPHTHALMOLOGY 2011. [DOI: 10.1586/eop.11.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
11
|
Lipps J, Khan MA. Vogt–Koyanagi–Harada syndrome: a rheumatologic perspective. ACTA ACUST UNITED AC 2010. [DOI: 10.2217/ijr.10.2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
12
|
Han HJ, Kim HY, Park JH, Lee EJ, Kim DG, Shin DI. Magnetic resonance imaging of pachymeningeal enhancement in Vogt-Koyanagi-Harada disease. Neurol Sci 2010; 31:785-8. [DOI: 10.1007/s10072-010-0236-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2009] [Accepted: 01/27/2010] [Indexed: 11/30/2022]
|
13
|
Liu GT, Volpe NJ, Galetta SL. Vision loss. Neuroophthalmology 2010. [DOI: 10.1016/b978-1-4160-2311-1.00004-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
|
14
|
Marchioni E, Minoli L. Headache attributed to infections nosography and differential diagnosis. HANDBOOK OF CLINICAL NEUROLOGY 2010; 97:601-26. [PMID: 20816458 DOI: 10.1016/s0072-9752(10)97052-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Headache is a very frequent symptom of infection. It has many possible underlying mechanisms, of which two or more can coexist in a single patient. It can be caused by direct stimulation of intracranial pain-producing structures, as in the case of brain abscesses, by irritation of the pachy- and leptomeninges, as in cases of bacterial or viral meningitis, or by a state of intracranial hypertension, as seen in obstructive hydrocephalus. There is no doubt that headache is often the first or the predominant symptom of serious, sometimes life-threatening, infectious diseases; certainly, it is a condition frequently encountered in all epidemiological studies. Indeed, it is estimated that over 60% of people have, at some point in their lives, experienced headache during an infection. This evidence leads to the need for a systematic approach to headache secondary to infection. This chapter provides some elements on pain mechanisms in systemic and intracranial infections and on the possible role of antimicrobial agents in the genesis of headache. The first section provides a detailed "etiology-based" description of the International Classification of Headache Disorders, 2nd edition (ICHD-II: Headache Classification Subcommittee of the International Headache Society, 2004), while the second section presents a "symptom-based" algorithm applicable in the first diagnostic assessment, according to the headache features and to the most frequently associated clinical manifestations during infections of the central nervous system (CNS).
Collapse
Affiliation(s)
- E Marchioni
- Fondazione Istituto Neurologico Nazionale C. Mondino, IRCCS, Pavia, Italy.
| | | |
Collapse
|
15
|
Rao NA, Gupta A, Dustin L, Chee SP, Okada AA, Khairallah M, Bodaghi B, Lehoang P, Accorinti M, Mochizuki M, Prabriputaloong T, Read RW. Frequency of distinguishing clinical features in Vogt-Koyanagi-Harada disease. Ophthalmology 2009; 117:591-9, 599.e1. [PMID: 20036008 DOI: 10.1016/j.ophtha.2009.08.030] [Citation(s) in RCA: 112] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2009] [Revised: 08/17/2009] [Accepted: 08/21/2009] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To determine the frequency of occurrence of limited clinical features which distinguish patients with Vogt-Koyanagi-Harada (VKH) disease from those with non-VKH uveitis. DESIGN Comparative case series. PARTICIPANTS We included 1147 patients. METHODS All patients with bilateral ocular inflammatory disease presenting to any of 10 uveitis centers in the 3-month period between January 1 and March 31, 2006 (inclusive), were asked to participate. The clinical and historical features of disease were obtained from the participants via direct interview and chart review. Patients were stratified based on whether they were diagnosed with VKH disease or non-VKH uveitis for statistical analysis. MAIN OUTCOME MEASURES Presence or absence of various clinical features in the 2 populations. RESULTS Of 1147 patients, 180 were diagnosed with VKH disease and 967 with non-VKH uveitis. Hispanics and Asians were more likely to be diagnosed with VKH than non-VKH disease compared with other ethnicities. In acute disease, the finding of exudative retinal detachment was most likely to be found in VKH disease with a positive predictive value (PPV) of 100 and negative predictive value (NPV) of 88.4, whereas in chronic disease, sunset glow fundus was most likely to be found, with a PPV of 94.5 and NPV of 89.2. CONCLUSIONS Numerous clinical findings have been described in the past as important in the diagnosis of VKH. The current study reveals that of these, 2 are highly specific to this entity in an ethnically and geographically diverse group of patients with nontraumatic bilateral uveitis. These clinical findings are exudative retinal detachment during acute disease and sunset glow fundus during the chronic phase of the disease.
Collapse
Affiliation(s)
- Narsing A Rao
- Doheny Eye Institute and Department of Ophthalmology, Keck School of Medicine of University of Southern California, Los Angeles, California 90033, USA.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
16
|
Kim LA, Khurana RN, Parikh JG, Rao NA. Melanin-Laden Macrophages in the CSF to Diagnose Vogt-Koyanagi-Harada Simulating Ocular Syphilis. Ocul Immunol Inflamm 2009; 16:59-61. [DOI: 10.1080/09273940801899806] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
17
|
Greer DM, Friday RP, Romero J, Auluck PK. Case records of the Massachusetts General Hospital. Case 17-2009. A 30-year-old man with progressive neurologic deficits. N Engl J Med 2009; 360:2341-51. [PMID: 19474432 DOI: 10.1056/nejmcpc0810842] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- David M Greer
- Department of Neurology, Massachusetts General Hospital, USA
| | | | | | | |
Collapse
|