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Treatment of Vogt-Koyanagi- Harada's disease during pregnancy
N Miyata1, M Sugita, S Nakamura
1Department of Ophthalmology, Yokohama City University School of Medicine, Yokahama, Japan.
Background:
Caution should be exercised in treating patients with autoimmune diseases during pregnancy.
Cases:
We successfully treated three cases of Vogt-Koyanagi-Harada's disease (VKH disease) during pregnancy.
Observations:
In the second trimester (14-27 weeks) of 1 patient, inflammation was mild and could be treated by topical corticosteroid. There is the possibility that her immune response had been modified by pregnancy. Systemic corticosteroid in a high dose was administered to the two cases in the second and third trimesters of pregnancy (28-41 weeks). The severity of inflammation in these 2 patients was similar to that in nonpregnant women. Inflammation subsided immediately without recurrence in all cases. No abnormality was found during the deliveries or in the babies.
Conclusions:
Treatment for VKH disease during pregnancy should be chosen according to the severity of inflammation, the stage of pregnancy, and the maternal and fetal conditions.