Background VKHS is a rare cause of granulomatous uveitis leading to significant visual loss in patients who develop it, usually accompanied with extraocular manifestations that include meningismus, vitiligo, poliosis, and hearing loss. In our country is responsible for 13% to 27% of all uveitis, affecting mainly young women.
Objectives To describe the presence of inflammatory arthritis in patients with VKHS at a third level hospital.
Methods A cross-sectional study of 4 patients with established VKHS that fulfilled the 2001 revised diagnostic criteria for Vogt-Koyanagi-Harada disease (1) was rolled out. Ultrasonography was performed to all patients by a trained rheumatologist in carpal, metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints evaluating presence of power Doppler (PD) signal, bone erosions, and cartilage changes.
Results We included 3 women and 1 man, mean age was 34.7±10.3 years, and they all had characteristics of complete VKHS. Mean disease duration (since first manifestation of ocular symptoms) was 5.2±3.5 months. One patient had synovitis on physical examination. Out of the 4 patients with PD signal, 4 had involvement of both wrist, MCP and PIP joints consistent with polyarthritis pattern, and bone erosions were detected in one patient (Table)
Conclusions The presence of inflammatory arthritis in patients with VKHS has only been described in one case (2). Despite the exceptionality, we propose that polyarthritis and probably erosive arthritis can represent part of the spectrum of the disease, processes that share some features of the genetic susceptibility with rheumatoid arthritis as HLA-DR4, CTLA-4 and STAT4.
Read RW, et al. Revised diagnostic criteria for Vogt- Koyanagi-Harada disease: report of an international committee on nomenclature. Am J Ophthalmol 2001; 131:647–652.
Aydin T, et al. Association of Vogt Koyanagi Harada Syndrome and Seronegative Rheumatoid Arthritis. Ethiopian Journal of Health Sciences. 2016;26(2):193–196.
Disclosure of Interest None declared