Application of revised diagnostic criteria for Vogt-Koyanagi-Harada disease in Japanese patients
Application of revised diagnostic criteria for Vogt-Koyanagi-Harada disease in Japanese patients
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DOI：
10.1007/s10384-004-0165-9
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发表时间：
2005-03-01
影响因子：
2.4
通讯作者：
Sakuragi, S
中科院分区：
文献类型：
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作者：
Yamaki, K;Hara, K;Sakuragi, S
目的：探讨Vogt-Koyanagi-Harada(VKH)病国际修订诊断标准是否适用于日本VKH病早期患者。这些患者在1989至2001年间在秋田大学医学院医院接受了检查，他们的平均年龄为47.6岁，年龄范围为15至69岁。在我们的研究中，患者被分为两组：全部早期组。包括那些在出现体征或症状的1个月内进行检查的人。晚发组，包括出现体征或症状超过1个月后检查的患者。根据眼底镜、荧光素血管造影术进行初步诊断。脑脊液细胞增多症和人类白细胞抗原(人类白细胞抗原)基因分型。结果：在我们的回顾性研究中，49例患者中有41例被置于早期组，S被置于晚期组。当按修订的诊断标准分类时，早期组的41名患者中有39名被诊断为不完全VKH，另外2名患者被诊断为非VKH病。这些患者都不会被诊断为完全的VKH病。即使在症状或体征出现2周后也是如此。在期末考试中。根据修订的诊断标准，仍有35名患者被归类为不完全VKH病，只有6名患者被归类为完全性VKH病。在晚期组，所有患者在出现任何体征或症状后2周即可诊断为不完全性VKH。在最后的检查中，8名患者中有2名仍将被诊断为不完全VKH，另外6名患者将被诊断为完全VKH。皮肤表现出现较晚，从发病到发现的平均时间为143.5天。结论：虽然修订后的诊断标准对VKH病的最终诊断是有效的，但不是日本VKH病早期诊断的有效工具。
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 14 age was 47.6 years with a range of 15 to 69 years. In our study, the patients were divided into two groups: all 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 filial 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 S 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 9 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.