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Vgot-小柳–原田综合征1例并文献复习
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Abstract:
Vgot-小柳–原田综合征的眼内表现为双侧弥漫渗出性肉芽肿全葡萄膜炎，具有反复发作的临床特点，是一种难治性系统性自身免疫疾病，临床表现为头痛、眼葡萄膜炎、脑膜脑炎、中枢神经系统改变以及听觉异常，同时还伴随毛发改变和皮肤脱色素等，疾病尚无确切的发病机制，临床表现多不典型，极易误诊和漏诊。本文报道1例最初诊断为病毒性脑炎并以试验性治疗，最终确诊为Vgot-小柳–原田综合征，应及早规范应用激素以延缓病情进展，减少并发症，进而改善患者预后。
The intraocular manifestations of Vgot-Koyanagi-Harada syndrome (VKHS) are bilateral diffuse exudative granuloma panuveitis with recurrent clinical characteristics. It is a refractory systemic autoimmune disease with clinical manifestations including headache, ocular uveitis, meningoencephalitis, central nervous system changes and hearing abnormalities, accompanied by hair changes and skin depigmentation. There is no exact pathogenesis of the disease, the clinical manifestations are atypical, and it is easy to misdiagnose and omission. In this paper, we report a case of viral encephalitis initially diagnosed and treated experimentally, and finally diagnosed as Vgot-Koyanagi-Harada syndrome. Early and standardized use of hormones should be used to delay the progression of the disease, reduce complications, and improve the prognosis of the patient.
| [1] | Bruno, M.G. and McPherson Jr., S.D. (1949) Harada’s Disease. American Journal of Ophthalmology, 32, 513-522. https://doi.org/10.1016/0002-9394(49)90876-4 |
| [2] | Shivaram, S., Nagappa, M., Seshagiri, D.V., et al. (2021) Vogt-Koyanagi-Harada Syndrome—A Neurologist’s Perspective. Annals of Indian Academy of Neurology, 24, 405-409. https://doi.org/10.4103/aian.AIAN_405_20 |
| [3] | Joye, A. and Suhler, E. (2021) Vogt-Koyanagi-Harada Disease. Current Opinion in Ophthalmology, 32, 574-582. https://doi.org/10.1097/ICU.0000000000000809 |
| [4] | Sugita, S., Takase, H., Kawaguchi, T., et al. (2007) Cross-Reaction between Tyrosinase Peptides and Cytomegalovirus Antigen by T Cells from Patients with Vogt-Koyanagi-Harada Disease. International Ophthalmology, 27, 87-95. https://doi.org/10.1007/s10792-006-9020-y |
| [5] | Ye, Z., Wu, C., Zhang, N., et al. (2020) Altered Gut Microbiome Composition in Patients with Vogt-Koyanagi-Harada Disease. Gut Microbes, 11, 539-555. https://doi.org/10.1080/19490976.2019.1700754 |
| [6] | Ruokonen, P.C., Metzner, S., Ucer, A., Torun, N., Hofmann, J. and Pleyer, U. (2010) Intraocular Antibody Synthesis against Rubella Virus and Other Microorganisms in Fuchs’ Heterochromic Cyclitis. Graefe’s Archive for Clinical and Experimental Ophthalmology, 248, 565-71. https://doi.org/10.1007/s00417-009-1239-7 |
| [7] | Rao, N.A., Sukavatcharin, S. and Tsai, J.H. (2007) Vogt-Koyanagi-Harada Disease Diagnostic Criteria. International Ophthalmology, 27, 195-199. https://doi.org/10.1007/s10792-006-9021-x |
| [8] | Tian, S., Yao, J., Wang, J., et al. (2021) [Autofluorescence Combined with Spectral Domain Optical Coherence Tomography for Diagnosis and Follow-Up of Acute Vogt-Koyanagi-Harada Disease. Journal of Southern Medical University, 41, 135-40. |
| [9] | Chen, L., Chang, R., Pan, S., et al. (2020) Plasma Metabolomics Study of Vogt-Koyanagi-Harada Disease Identifies Potential Diagnostic Biomarkers. Experimental Eye Research, 196, Article ID: 108070. https://doi.org/10.1016/j.exer.2020.108070 |
| [10] | Dinges, S., Hohm, A., Vandergrift, L., et al. (2019) Cancer Metabolomic Markers in Urine: Evidence, Techniques and Recommendations. Nature Reviews Urology, 16, 339-362. https://doi.org/10.1038/s41585-019-0185-3 |
| [11] | Schmidt, C. (2009) Urine Biomarkers May Someday Detect Even Distant Tumors. Journal of the National Cancer Institute, 101, 8-10. https://doi.org/10.1093/jnci/djn482 |
| [12] | Li, M., Zhao, M. and Gao, Y. (2014) Changes of Proteins Induced by Anticoagulants Can Be More Sensitively Detected in Urine Than in Plasma. Science China Life Sciences, 57, 649-656. https://doi.org/10.1007/s11427-014-4661-y |
| [13] | Nicholson, J., Lindon, J. and Holmes, E. (1999) “Metabonomics”: Understanding the Metabolic Responses of Living Systems to Pathophysiological Stimuli via Multivariate Statistical Analysis of Biological NMR Spectroscopic Data. Xenobiotica: The Fate of Foreign Compounds in Biological Systems, 29, 1181-1189. https://doi.org/10.1080/004982599238047 |
| [14] | 陈琳. 血浆代谢组学分析Vogt-小柳原田综合征的潜在诊断标志物[D]: [硕士学位论文]. 重庆: 重庆医科大学, 2020. |
| [15] | Hu, Y., Hu, Y., Xiao, Y., et al. (2020) Genetic Landscape and Autoimmunity of Monocytes in Developing Vogt-Koyanagi-Harada Disease. Proceedings of the National Academy of Sciences of the United States of America, 117, 25712-25721. https://doi.org/10.1073/pnas.2002476117 |
| [16] | Takayama, K., Obata, H. and Takeuchi, M. (2020) Efficacy of Adalimumab for Chronic Vogt-Koyanagi-Harada Disease Refractory to Conventional Corticosteroids and Immunosuppressive Therapy and Complicated by Central Serous Chorioretinopathy. Ocular Immunology and Inflammation, 28, 509-512. https://doi.org/10.1080/09273948.2019.1603312 |
| [17] | Hosoda, Y., Hayashi, H. and Kuriyama, S. (2015) Posterior Subtenon Triamcinolone Acetonide Injection as a Primary Treatment in Eyes with Acute Vogt-Koyanagi-Harada Disease. The British Journal of Ophthalmology, 99, 1211-1214. https://doi.org/10.1136/bjophthalmol-2014-306244 |
| [18] | Park, J.G., Callaway, N.F., Ludwig, C.A., et al. (2020) Intravitreal Methotrexate and Fluocinolone Acetonide Implantation for Vogt-Koyanagi-Harada Uveitis. American Journal of Ophthalmology Case Reports, 19, Article ID: 100859. https://doi.org/10.1016/j.ajoc.2020.100859 |
| [19] | Chen, Z., Zhong, Z., Zhang, W., et al. (2020) Integrated Analysis of Key Pathways and Drug Targets Associated with Vogt-Koyanagi-Harada Disease. Frontiers in Immunology, 11, Article ID: 587443. https://doi.org/10.3389/fimmu.2020.587443 |
