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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Vogt-Koyanagi (V-K) syndrome is a severe anterior uveitis associated with alopecia, vitiligo, poliosis, and dysacousia. Harada's disease (HD) is primarily a posterior uveitis accompanied by signs of meningeal irritation and abnormalities of the cerebrospinal fluid. The overlapping of clinical manifestations between the two justified considering them as part of a spectrum of one disease (V-K-H). In a clinicopathologic study of nine cases four patients (three with V-K syndrome and one with V-K-H syndrome) histopathologically displayed a granulomatous uveitis. Five patients (two with V-K syndrome and three with HD) showed a nongranulomatous uveitis. We emphasized this latter finding, since in the past the diagnosis of this syndrome has been discarded both clinically and histopathologically because of the absence of a granulomatous uveitis. We established the clinical and histopathologic differences between V-K-H and sympathetic ophthalmia. The designation "uveomeningoencephalitic syndrome" stresses the key features of V-K-H, namely the uveal involvement and signs of meningeal irritation (that is, headaches, personality changes, and cerebrospinal fluid alterations).
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PMID:Clinical and histopathologic observations in severe Vogt-Koyanagi-Harada syndrome. 83 66

Thirty-six patients with vitiligo were treated with oral 5-methoxypsoralen (5-MOP) and subsequently exposed to UVA irradiation. The patients were treated once or twice weekly over a period of 2-10 months, taking 40-60 mg of 5-MOP 2 hours before exposure to UVA light. The amount of exposure to UVA light was slowly increased according to the patient's tolerance. Eleven (31%) patients showed remarkable repigmentation of the areas of vitiligo within six months. Overall, 78% of the patients showed effective repigmentation. Areas of vitiligo on the face and trunk were more responsive to treatment than those on the distal part of limbs. Adverse effects due to the drug included 2 patients with nausea and 1 patient with headache. It is suggested that treatment with systemic 5-MOP is effective, safe, and useful in selected cases of vitiligo.
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PMID:Treatment of vitiligo with oral 5-methoxypsoralen. 193 61

Vogt-Koyanagi-Harada syndrome is a rare disease, which probably has a cell-mediated autoimmune pathogenesis, marked by ocular (anterior and/or posterior uveitis), dermatological (poliosis, canities, vitiligo) and neurological (meningo-encephalitis) disorders of variable severity in variable combinations. The clinical pattern in the case reported here showed severe neurological involvement (headache, ataxia and confusional state) followed by anteroposterior uveitis. Instrumental investigations (cerebrospinal fluid, VEPs, BAEPs, EEG, CT and MRI brainscans) confirmed the diagnosis. The response to cortisone therapy was excellent. We emphasize the importance of the neuroradiological investigations, because of their peculiarities, and review the reports of cases with marked meningo-encephalitic impairment, given the dearth of reports in the neurological journals.
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PMID:Vogt-Koyanagi-Harada syndrome: clinical and instrumental contribution. 195 5

Forty-eight cases of the Vogt-Koyanagi-Harada (VKH) syndrome occurring in patients residing in southern California were reviewed. Thirty-six patients were Hispanic and 12 of other racial groups. Symptoms of meningismus, predominantly headache, were present in 32 (67%) cases, but the other characteristic neurologic symptoms, i.e., tinnitus and dysacusis, were present in only eight (17%) and six (13%) cases, respectively. Dermatologic changes were rare; vitiligo occurred in five (10%) patients, alopecia in six (13%), and poliosis in three (6%). In this patient population, extraocular signs and symptoms of the VKH syndrome, other than headache, were unusual. The ocular manifestations of the VKH syndrome are more constant and include iridocyclitis, vitritis, diffuse swelling of the choroid, serous retinal detachment, and optic disc hyperemia. Procedures that may aid in the diagnosis include lumbar puncture, fluorescein angiography, and standardized echography. The ophthalmologist must be prepared to make this diagnosis and initiate treatment with high-dose systemic steroids based on the typical ocular findings even in the absence of other (extraocular) manifestations of this disease.
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PMID:Variations in clinical features of the Vogt-Koyanagi-Harada syndrome. 196 85

A 45-year-old Japanese man, who had had bilateral visual disturbance due to Vogt-Koyanagi-Harada (VKH) disease 17 years before entry, was admitted to this hospital because of headache, vertigo and vomiting. On examination at entry, no abnormalities except for poliosis, patches of vitiligo on his left shin, sunset glow fundus, and positional nystagmus with Frenzel glasses were found. Laboratory data other than leukocytosis and elevated level of gamma-GTP were normal and the results of brain CT scan were within normal limits. On the following day, diplopia was developed and the neurological symptoms including loss of bilateral visual acuity, Horner's syndrome on the right side, right facial palsy, bilateral sensorineural hearing disturbance, palsy of the soft palate on the right side with swallowing difficulty, and dissociated sensory disturbance on the right face and the upper and lower extremities on the left side appeared with a few days. He couldn't get up. The cerebrospinal fluid (CSF) was clear and had pleocytosis with normal sugar content. The protein, immunoglobulin G and myelin basic protein (MBP) were elevated but the tests for oligoclonal band and antiviral antibodies were negative. Brain CT scan showed low density areas in right cerebellar hemisphere and in left putamen without abnormality with contrast material and evoked potentials were normal. Prednisolone was prescribed and his symptoms were subsided but his gait remained ataxic. Magnetic resonance imaging (MRI) 4 months later showed an atrophy of the lower half of bilateral cerebellar hemisphere supplied by posterior inferior cerebellar artery, suggesting cerebellar infarction, and high intensity areas on T2 image in bilateral cerebral white matters, basal ganglia, and left cerebral peduncle.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Wallenberg's syndrome in a case of Vogt-Koyanagi-Harada disease]. 261 5

139 patients with vitiligo of long duration were treated with oral 8-MOP and UVA. 22 patients had focal and 117 generalized vitiligo. 27 had vitiligo on the skin of their face and/or neck and 58 on their hands and/or feet. Vitiligo of the face and/or neck responded very well to the treatment, 14 of 27 (52%) repigmenting completely, while the treatment results of hands and/or feet were poor (complete repigmentation in 2 of 58 cases (3%). In cases with focal vitiligo total repigmentation was observed much more frequently (in 11 of 22 cases) than in cases with generalized vitiligo (in 23 of 117 cases). Acute toxic effects were frequent, erythema in 55 cases (40%), nausea in 46 cases (33%), pruritus in 16 cases (12%) and headache in 8 cases (6%). Long-term adverse effects such as hypertrichosis and actinic keratoses occurred in 3 cases each. 6 patients (4%) had elevated transminases at some stage of the treatment. This did not cause withdrawal from treatment in any of the cases.
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PMID:Treatment of vitiligo with oral methoxsalen and UVA. 653 Dec 91

We examined a 67-year-old man who complained of headache and pain and decreased visual acuity in both eyes. The patient had dilated conjunctival and episcleral vessels, intracameral cells, shallow anterior chambers, hyperemic swollen optic disks, exudative retinal detachment and choroidal detachment. Fluorescein angiography showed leakage of dye from the optic disks and choroid into the subretinal space. Scleral thickening was found by computed tomography. These abnormal findings disappeared within 1 week after treatment with a systemic corticosteroid. Laboratory test results showed positive rheumatoid factor. Sunset glow fundi and vitiligo developed a few months after the treatment. We believe that concurrent bilateral posterior scleritis, Vogt-Koyanagi-Harada disease and positive rheumatoid factor, as demonstrated in our patient, may be rare.
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PMID:Concurrent bilateral posterior scleritis and Vogt-Koyanagi-Harada disease in a patient with positive rheumatoid factor. 928 10

We describe the exceptional association of Vogt-Koyanagi-Harada syndrome (VKHS) and hypothyroidism in a 29-year-old man of Indian heritage. VKHS is a rare uveomeningoencephalitic syndrome with probably autoimmune pathogenesis. Nontraumatic uveitis, aseptic meningoencephalitis, vitiligo, alopecia and poliosis are the leading clinical features of VKHS. The reported patient presented with bilateral visual loss and progressive frontal headache. VKHS was diagnosed due to characteristic ophthalmological findings and the diagnosis of aseptic meningitis. Due to the autoimmune pathogenesis, VKHS may be rarely associated with other autoimmune disorders. Association of VKHS with autoimmune thyroid disease has been described in the literature in three patients. In the reported case hypothyroidism due to chronic autommune thyroiditis was diagnosed in association with VKHS. Routinely determination of thyroid function in patients with VKHS is recommended.
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PMID:Headache and bilateral visual loss in a young hypothyroid Indian man. 1019 82

The Vogt-Koyanagi-Harada (VKH) syndrome is an uncommon disorder characterized by uveitis and neurologic and cutaneous abnormalities, including tinnitus, vertigo, headache, meningoencephalitis, vitiligo, alopecia, and poliosis. The VKH syndrome has been reported to occur in association with other autoimmune disorders. We report a case of a patient with severe ulcerative colitis who developed VKH syndrome. We postulate that the patient's history of a traumatic brain injury might have been responsible for an abnormal "immunologic milieu" and the occurrence of ulcerative colitis, VKH syndrome, and severe reactive arthritis.
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PMID:Vogt-Koyanagi-Harada syndrome and ulcerative colitis. 1498 67

Vogt-Koyanagi-Harada (VKH) syndrome or uveomeningitic syndrome is a disease affecting several organs: eye (bilateral uveitis, exudative retinal detachments), ear (tinnitus, dysacousia), skin and hair (vitiligo, alopecia, poliosis) and the nervous system (meningism, headache, pleocytosis in cerebrospinal fluid). The etiology remains unknown but it is probably a cell-mediated autoimmune disorder in individuals genetically susceptible to antigenic components of melanocytes. We report a 25 year old patient with VKH syndrome treated with intravenous steroid therapy and cycles of intravenous immunoglobulin with good clinical response. We concluded that treatment of the VKH syndrome should be early but definitely aggressive with high doses of systemic corticosteroids and intravenous immunoglobulin, assessing the maintenance of the latter by cycles.
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PMID:[Intravenous immunoglobulin therapy in Vogt-Koyanagi-Harada syndrome]. 1527 90


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