[Ulcerative colitis associated with Vogt-Koyanagi-Harada disease]

Area of Science:

• Neuro-ophthalmology
• Gastroenterology
• Neurology

Background:

• Vogt-Koyanagi-Harada (VKH) disease is a multisystem inflammatory disorder.
• Neurological complications, including myelopathy, are rare but significant in VKH disease.
• The association between VKH disease and ulcerative colitis (UC) is infrequently reported.

Observation:

• A 14-year-old female diagnosed with VKH disease developed myelopathy with paraparesis.
• Cerebral MRI revealed periventricular white matter T2-hyperintense lesions suggestive of demyelination.
• Twelve years post-VKH diagnosis, UC was diagnosed due to abdominal pain and bloody diarrhea.

Findings:

• The patient's neurological manifestations complicated UC management.
• Anti-TNF therapy, while used for VKH-associated uveitis, was withheld due to neurological concerns and demyelinating lesions.
• This case underscores the complexity of managing co-existing autoimmune conditions.

Implications:

• Further research is needed on the neurological manifestations of VKH disease.
• Careful consideration of treatment strategies is crucial when autoimmune disorders overlap.
• This case contributes to the limited literature on the co-occurrence of VKH disease and ulcerative colitis.