A case of recalcitrant pediatric Vogt-Koyanagi-Harada disease successfully controlled with adalimumab.

Abstract

Vogt-Koyanagi-Harada (VKH) disease is uncommon in the pediatric population and can have an aggressive course with serious visual sequelae. A 12-year-old Han Chinese American female, who presented with mild headaches and panuveitis with diffuse serous retinal detachments, was diagnosed with VKH. Despite treatment with a combination of high-dose systemic corticosteroids, intravitreal triamcinolone injection, and mycophenolate mofetil, ocular inflammation was inadequately controlled. Addition of adalimumab allowed for inflammation remission, improvement of vision, and tapering of systemic corticosteroids. Escalation of immunosuppression until remission appears to be critical in this population. Further research is needed to understand the complex pathophysiology of VKH and investigation for similar efficacy of other anti-tumor necrosis factor-alpha agents will need to be performed.

• Authors: Emily Su, Vikash S Oza, Paul Latkany
• Journal: Journal of the Formosan Medical Association = Taiwan yi zhi (J Formos Med Assoc) Vol. 118 Issue 5 Pg. 945-950 (May 2019) ISSN: 0929-6646 [Print] Singapore
• PMID: 30616991 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2018 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.

Chemical References

• Tumor Necrosis Factor-alpha
• Triamcinolone
• Adalimumab
• Mycophenolic Acid

Topics

• Adalimumab (administration & dosage)
• Child
• Drug Therapy, Combination
• Female
• Fluorescein Angiography
• Headache (etiology)
• Humans
• Mycophenolic Acid (administration & dosage)
• Panuveitis (drug therapy, etiology)
• Remission Induction
• Tomography, Optical Coherence
• Triamcinolone (administration & dosage)
• Tumor Necrosis Factor-alpha (antagonists & inhibitors)
• Uveomeningoencephalitic Syndrome (diagnosis, drug therapy)
• Visual Acuity