Maladie de Vogt Koyanagi Harada chez un jeune homme compliquée d’une réactivation de tuberculose et d’une vasculite occlusive rétinienne
(2020) Louvain médical — Vol. 139, n° 8, p. 479-484 (2020)
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- Abstract
- (en) [Vogt-Koyanagi-Harada disease in a young man, which was complicated by tuberculosis reactivation and occlusive retinal vasculitis] We report the case of a 17-year-old man presenting with bilateral visual loss, panuveitis, exudative retinal detachments, and diffuse choroidal infiltration. The patient also complained of headaches and ear pain. Based on the fundus image analysis, fluoangiography, indocyanine green angiography, and optical coherence tomography, Vogt-Koyagani-Harada disease was diagnosed. The patient received high-dose methylprednisolone along with azathioprine. He responded well to treatment with progressive visual improvement and subretinal fluid disappearance. One month later, his right eye exhibited a sectorial retinal vasculitis with inferotemporal vein branch occlusion and massive subretinal hemorrhages. Coagulation screening as well as HIV and syphilis serology were all negative; whereas QuantiFERON was positive. An 18F-FDG PET/CT revealed hypermetabolic mediastinal lymph nodes, and a biopsy confirmed active tuberculosis (TB) infection. Anti-TB quadritherapy was initiated, resulting in cytochrome P450 enzyme induction and lowered steroid treatment efficacy, with consecutive recurrence of choroidal inflammation.
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Citations
Bouterfa, Z., Yildiz, H., Yombi, J. C., & Kozyreff, A. (2020). Maladie de Vogt Koyanagi Harada chez un jeune homme compliquée d’une réactivation de tuberculose et d’une vasculite occlusive rétinienne. Louvain médical, 139(8), 479-484. https://hdl.handle.net/2078.5/168867 (Original work published 2020)