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Primed Mycobacterial Uveitis PMU as a Model for Post-Infectious Uveitis
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Tubercular Harada disease - An unreported uveitic entity
Ranju Kharel Sitaula1, Preeti Agrawal1
1Department of Ophthalmology, Maharajgunj Medical Campus, B. P. Koirala Lions Centre for Ophthalmic Studies, Tribhuvan University, Institute of Medicine, Kathmandu, Nepal.
Annals of Medicine and Surgery (2012)
|September 1, 2022
Summary
Ocular tuberculosis and Vogt Koyanagi Harada disease can co-occur, especially in TB-endemic regions. This study introduces "Tubercular Harada Disease" (THD) for panuveitis with mixed features, successfully managed with combined therapies.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Immunology
Background:
- Ocular tuberculosis and Vogt Koyanagi Harada disease (VKHD) are significant causes of panuveitis.
- In TB-endemic areas like Nepal, latent tuberculosis may present with VKHD features.
Observation:
- Two patients in Nepal presented with bilateral panuveitis and sunset glow fundus.
- Investigations revealed choroidal thickening, macular edema, and reduced P1 wave amplitude on ERG.
- Positive tuberculin skin and QuantiFERON Gold tests indicated tuberculosis.
Findings:
- Successful management of panuveitis with mixed features using corticosteroids, antitubercular therapy (ATT), and antimetabolites.
- Patients achieved normal visual acuity with no recurrence of uveitis after 9 months of treatment.
Implications:
- Proposes the term "Tubercular Harada Disease" (THD) for this specific clinical presentation.
- Suggests Mycobacterium could trigger VKHD in TB-endemic regions, necessitating combined treatment approaches.
Keywords:
Case reportGranulomatous uveitisImmunosuppressionMolecular mimicryTuberculosisVogt koyanagi harada diseaseMore Related Videos
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