Abstract |
Vogt-Koyanagi-Harada disease (VKHD) is a multisystemic disorder characterized by granulomatous panuveitis variably combined with T cell-mediated neurologic and cutaneous manifestations. Early and aggressive treatment with systemic corticosteroids is the mainstay of treatment for VKHD. Additional use of immunosuppressants, intravenous immunoglobulins, and tumor necrosis factor-alpha inhibitors can help the most severely affected patients and work as corticosteroid-sparing agents. We report the case of a young woman with relapsing and multiresistant VKHD who demonstrated a stable remission of both uveitis and high-frequency hearing loss following rituximab intravenous administration (1 g. twice, 2 weeks apart, and 6 months later). A complete clinical response was observed 1 month since the first infusion, and no ocular relapses were recorded during the following year; in addition, audiometry showed a high-frequency hearing recovery in the right ear. Further observational studies are required to define the role of CD20 inhibition in the management of VKHD.
|
Authors | Francesco Caso, Donato Rigante, Antonio Vitale, Luisa Costa, Vittoria Bascherini, Eugenia Latronico, Rossella Franceschini, Luca Cantarini |
Journal | Clinical rheumatology
(Clin Rheumatol)
Vol. 34
Issue 10
Pg. 1817-20
(Oct 2015)
ISSN: 1434-9949 [Electronic] Germany |
PMID | 25224382
(Publication Type: Case Reports, Journal Article)
|
Chemical References |
- Adrenal Cortex Hormones
- Anti-Inflammatory Agents, Non-Steroidal
- Antigens, CD20
- Immunoglobulins, Intravenous
- Immunosuppressive Agents
- Rituximab
- Dexamethasone
- Cyclosporine
- Prednisolone
- Prednisone
- Methylprednisolone
|
Topics |
- Administration, Oral
- Adolescent
- Adrenal Cortex Hormones
(chemistry, therapeutic use)
- Anti-Inflammatory Agents, Non-Steroidal
(therapeutic use)
- Antigens, CD20
(metabolism)
- Audiometry
- Cyclosporine
(adverse effects)
- Dexamethasone
(administration & dosage)
- Female
- Hearing Loss
(complications, therapy)
- Hearing Loss, Sensorineural
(pathology)
- Humans
- Immunoglobulins, Intravenous
(chemistry)
- Immunosuppressive Agents
(therapeutic use)
- Methylprednisolone
(administration & dosage)
- Panuveitis
(pathology)
- Prednisolone
(administration & dosage)
- Prednisone
(administration & dosage)
- Prognosis
- Recurrence
- Remission Induction
- Rituximab
(therapeutic use)
- Uveitis
(complications, pathology, therapy)
- Uveomeningoencephalitic Syndrome
(complications, drug therapy)
|