Acute myelitis in a patient with vogt-koyanagi-harada disease: case report and review of the literature

Abstract

Background: Vogt-Koyanagi-Harada (VKH) disease is characterized by bilateral granulomatous uveitis with neurologic, auditory, and dermatologic manifestations. However, acute myelitis complicating VKH disease has rarely been reported.

Case report: A 50-year-old Chinese Han woman presented with difficulty walking, numbness on the left side of the body, and difficulty with urination. The patient was diagnosed with incomplete VKH disease and received corticosteroid treatment prior to the neurological presentation. Acute myelitis was diagnosed based on both clinical and spinal-cord MRI findings.

Conclusions: Clinicians should consider acute myelitis as a rare possible neurological manifestation in VKH disease patients, and early systemic administration of corticosteroids will suppress the acute inflammatory process and prevent recurrences. This report raises the possibility that VKH disease and acute myelitis share common pathogenic pathways.

Keywords: Vogt-Koyanagi-Harada disease; acute myelitis; pathogenesis.

Fig. 1

Optical coherence tomography demonstrating serous detachment of both eyes (A and B). T2-weighted sagittal view of the spinal cord showing a hyperintense signal of the cord at the level of the C1-3 vertebrae (C), and contrast-enhanced sagittal view showing gadolinium enhancement at the same level (D).