PMID- 15838732
OWN - NLM
STAT- MEDLINE
DCOM- 20050524
LR  - 20221207
IS  - 0021-5155 (Print)
IS  - 0021-5155 (Linking)
VI  - 49
IP  - 2
DP  - 2005 Mar-Apr
TI  - Application of revised diagnostic criteria for vogt-koyanagi-harada disease in 
      Japanese patients.
PG  - 143-8
AB  - PURPOSE: To determine whether the International Revised Diagnostic Criteria for 
      Vogt-Koyanagi-Harada (VKH) disease is applicable to Japanese patients at the 
      early stage of VKH disease. METHODS: The medical records of 49 patients with VKH 
      disease were studied. The patients had been examined at the Akita University 
      School of Medicine Hospital between 1989 and 2001, and their mean age was 47.6 
      years with a range of 15 to 69 years. In our study, the patients were divided 
      into two groups; an Early Group, which consisted of those who were examined 
      within 1 month of the onset of signs or symptoms, and a Late Group, which 
      consisted of those who were examined more than 1 month after the onset of signs 
      or symptoms. The initial diagnosis was based on findings by ophthalmoscopy, 
      fluorescein angiography, pleocytosis of cerebrospinal fluid, and genotyping of 
      human leukocyte antigen (HLA). The final diagnosis was based on the presence of 
      these findings in addition to skin and internal ear manifestations of VKH 
      disease. RESULTS: In our retrospective study, 41 of the 49 patients were placed 
      in the Early Group, and 8 were placed in the Late Group. When classified by the 
      Revised Diagnostic Criteria, 39 of the 41 in the Early Group would have been 
      diagnosed with incomplete VKH, and the other 2 patients would have been diagnosed 
      as not having VKH disease. None of the patients would have been diagnosed as 
      having complete VKH disease, even at 2 weeks after the onset of symptoms or 
      signs. At the final examination, 35 patients would still have been classified as 
      having incomplete VKH disease, and only 6 patients would have been classified as 
      having complete VKH disease according to the Revised Diagnostic Criteria. In the 
      Late Group, all of the patients would have been diagnosed as having incomplete 
      VKH at 2 weeks after the onset of any signs or symptoms. At the final 
      examination, two of eight patients would still have been diagnosed as having 
      incomplete VKH, and the other six would have been diagnosed as having complete 
      VKH. The skin manifestations always appeared later than the other alterations, 
      with an average of 143.5 days from disease onset to detection. CONCLUSIONS: 
      Although the Revised Diagnostic Criteria are effective for making the final 
      diagnosis of VKH disease, they are not an effective tool for diagnosis at the 
      very early stage of VKH disease in Japanese patients.
FAU - Yamaki, Kunihiko
AU  - Yamaki K
AD  - Department of Ophthalmology, Akita University School of Medicine, Akita, Japan. 
      yamaki@oph.med.akita-u.ac.jp
FAU - Hara, Koji
AU  - Hara K
FAU - Sakuragi, Shozo
AU  - Sakuragi S
LA  - eng
PT  - Journal Article
PL  - Japan
TA  - Jpn J Ophthalmol
JT  - Japanese journal of ophthalmology
JID - 0044652
SB  - IM
MH  - Acute Disease
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Asian People/ethnology
MH  - *Diagnostic Techniques, Ophthalmological
MH  - Female
MH  - Fluorescein Angiography
MH  - Genotype
MH  - Humans
MH  - Japan/epidemiology
MH  - Leukocyte Count
MH  - Male
MH  - Middle Aged
MH  - Ophthalmoscopy
MH  - Practice Guidelines as Topic
MH  - Retrospective Studies
MH  - Uveomeningoencephalitic Syndrome/*diagnosis/ethnology
EDAT- 2005/04/20 09:00
MHDA- 2005/05/25 09:00
CRDT- 2005/04/20 09:00
PHST- 2004/01/29 00:00 [received]
PHST- 2004/09/04 00:00 [accepted]
PHST- 2005/04/20 09:00 [pubmed]
PHST- 2005/05/25 09:00 [medline]
PHST- 2005/04/20 09:00 [entrez]
AID - 10.1007/s10384-004-0165-9 [doi]
PST - ppublish
SO  - Jpn J Ophthalmol. 2005 Mar-Apr;49(2):143-8. doi: 10.1007/s10384-004-0165-9.