1/17/2024 0 Comments O negative blood type facts wiki![]() ![]() The clinical features of VKH disease will vary depending on stage of the disease. Note granulomatous deposits on corneal endothelium. Keratic precipitate due to Vogt-Koyanagi-Harada Disease. Immunocytology demonstrates uveal infiltrates composed of T-cells and HLA-DR+ macrophages non-dendritic appearing CD1 positive cells are in close proximity to melanocytes in the choroid. Dalen-Fuchs nodules representing granulomas between the RPE and Bruch’s membranes, can be observed. There is presence of a diffuse lymphocytic infiltration with collections of epithelioid cells and multi-nucleated giant cells. The primary pathological feature is a diffuse thickening of the uveal tract caused by a non-necrotizing granulomatous inflammation. HistopathologyĪ granulomatous process is seen during the acute phase, and a nongranulomatous inflammation is seen during the chronic phase. Although the exact target antigen has not been identified, possible candidates for target antigen include tyrosinase or tyrosinase-related proteins, an unidentified 75 kDa protein obtained from cultured human melanoma cells (G-361), and the S-100 protein. The trigger is unknown, but cutaneous injury, or viral infection have been reported as possible factors in some cases. The pathogenesis is unknown but theories revolve around the possibility that a T-cell mediated autoimmune reaction against one or more antigens associated with melanocytes, melanin, and retinal pigment epithelium (RPE) may play a major role in the disease. The disease appears to affect women more frequently than men, but no specific sex predilection has been established. There is an association with HLA-DR1 and HLA-DR4 (subtype 0405). VKH typically affects more pigmented groups, such as Hispanics, Asians, Native Americans, Middle Easterners, and Asian Indians, but not blacks of subSaharan African descent. Women have been reported as being more affected than men but this will vary depending on the population studied. The majority of the cases found are around the second and fifth decades of life. In Japan it accounts for 6.8% to 9.2% of uveitis cases, meanwhile in the United States it hovers around 1%-4%. The disease primarily affects pigmented races. The incidence of VKH will vary depending on the geographic location and the ethnicity encountered. Since there is much overlapping of signs and symptoms between the two entities, in 1932 Babel suggested to call the entity Vogt-Koyanagi-Harada disease. Harada’s disease, characterized by bilateral exudative uveitis accompanied by pleocytosis of cerebrospinal fluid.Vogt-Koyanagi syndrome, characterized by chronic severe anterior uveitis, alopecia, poliosis, cutaneous as well as perilimbal vitiligo (also known as Sugiura’s sign), and dysacusia.Originally, VKH disease was classified as two separate entities: Vogt-Koyanagi-Harada (VKH) disease is defined as a bilateral granulomatous panuveitis with or without extraocular manifestations affecting young adults. 6.2 Indocyanine Green Angiography (ICG).6.1 Fundus Fluorescein Angiography (FFA). ![]()
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