Headache in late pregnancy: a symptom for Vogt-Koyanagi-Harada disease

Headache in late pregnancy is warning of the presence of severe and/or lethal disorders. Here, we present a case of Vogt-Koyanagi-Harada disease (VKH), in which headache was the preceding and predominant symptom. At 37 weeks of pregnancy, a Japanese 1-para woman with an uneventful pregnancy complained of severe headache and then blurred vision. Although we initially diagnosed this condition as pregnancy-associated retinal detachment, headache and blurred vision persisted after delivery. Eye anterior segment lesions appeared and VKH disease was diagnosed, with systemic steroid administration completely ameliorating both the headache and visual disturbance. Obstetricians must be aware that headache may be the first sign of VKH disease.