Article

Vogt-Koyanagi-Harada's disease: literature review

International Archives of Otorhinolaryngology 01/2008;
Source: DOAJ

ABSTRACT Introduction: Vogt-Koyanagi-Harada's disease is a rare syndrome that affects tissues with melanocytes like eyes, central nervous system, skin and inner ear. It affects primarily Asians, Indians and Latin Americans and also women. Objective: To review in the literature the several aspects of Vogt-Koyanagi-Harada's disease focusing on its cause and also to study its otolaryngology aspects through online databases Cochrane, LILACS, MEDLINE, OMIM e SciELO. Literature Review: This exact cause remains unknown, but there are evidences of an autoimmune process against an antigenic component on the melanocyte configuring an inflammatory T-cell-mediated immune response. The HLADRB1* 0405 allele is the one that is most associated to the disease. The clinic manifestations are divided in four: prodromal, uveitic, chronic and recurrence stages. The otolaryngology's aspects occur at the uveitic stage. Hearing loss is sensorineural bilateral and quickly progressive and could be associated with tinnitus. The vestibular component is less affected with vertigo, nystagmus and abnormal vestibular reflex. The otolaryngology's manifestations do not influence the recurrences or complications and they also have great prognosis with the treatment established. The diagnosis of this syndrome is based on clinical criteria, but audiological test could help. The therapy is corticosteroid-based. Final Comments: The most important factor for prognosis is the immediately treatment. The rarity of this syndrome makes its diagnosis a challenge and the presence of deafness, tinnitus and vertigo must consider its diagnosis.

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