Melanin-Laden Macrophages in Cerebrospinal Fluid in Vogt-Koyanagi-Harada Syndrome

The spectrum of Vogt-Koyanagi-Harada disease in Tunisia, North Africa

“…Lumbar puncture, showing pleocytosis that consists mainly of lymphocytes, has been advocated as a useful adjunctive diagnostic tool by some authors [5,15]. However, our results, consistent with those of most previous reports, showed that this procedure is rarely necessary.…”

Application of revised diagnostic criteria for Vogt-Koyanagi-Harada disease in Japanese patients

“…These observations confirmed that spinal fluid analysis is an important test for the early diagnosis of VKH disease, as has been previously reported. [16][17][18][19] The integumentary signs or symptoms always developed later than the other signs or symptoms and were detected in only 6 of 41 (14.6%) patients in the Early Group and 6 of 8 (75%) in the Late Group, for a total of 12 (24.5%). An average of 169.2 days (143.5 in the Early Group, 194.8 in the Late Group) passed from the onset of any signs or symptoms before the development of the integumentary changes (Tables 2, 3).…”

Short Report

“…VKHS is presumably triggered by autoantibodies against skin, leptomeningeal, retinal, uveal and inner ear melanocytes [2,5]. In our patient, the immunopathogenesis was supported by the slight lymphocyte pleocytosis, increased CSF IgG, the abnormal serum immunoglobulins, the negative response to the antimicrobial therapy, the infections that preceded the neurological impairment and the excellent response to corticosteroids.…”

“…Additionally, pleocytosis may persist for years and may not be related to the neurologic impairment. Among somnolence, agitation, aggression, confusional state, neuropsychological deficits, headache, meningismus, vertigo, cranial neuropathy, hemiparesis, and pleocytosis [1][2][3][5][6][7][8], pleocytosis is the most frequent neurologic abnormality in VKHS, disappearing within a few weeks after onset [1,3,9]. In our patient, pleocytosis persisted for at least 18 months and neurological symptoms occurred without concomitant ocular symptoms.…”