Vogt-Koyanagi Harada Disease in Pediatric Age

Abstract

Vogt-Koyanagi-Harada syndrome, originally known as uveomeningitic syndrome, is a chronic multisystem autoimmune disease characterized by bilateral granulomatous panuveitis with exudative retinal detachment and papillitis. It affects melanocyte-rich tissues such as the eye, inner ear, meninges, skin and hair. A 10-year-old male patient presents with ocular pain and decreased vision in both eyes. Biomicroscopy of the anterior segment showed graying of the eyebrows, moderate cilio-conjunctival injection, mild corneal edema, keratic precipitates in mutton fat, 3+ cellularity in anterior chamber, iris transillumination in periphery, posterior synechiae in 360 degrees in right eye and opacity of the lens in both eyes. In the general physical examination, graying of the hair and hypopigmented spots in different parts of the body were observed. Treatment was based on the suppression of intraocular inflammation with early and prolonged use of systemic corticosteroids and immunomodulators, in addition to the surgical treatments performed to treat the existing ocular complications. The presentation of this case reaffirms the importance of a quick and accurate diagnosis, in spite of being an infrequent disease in this age, it shows that it is necessary to know it in order to treat the complications and avoid irreversible sequelae such as blindness at such early ages of life when in the presence of a similar clinical picture.