A case of Vogt-Koyanagi-Harada disease associated with malignant lymphoma

Background: Vogt-Koyanagi-Harada disease (VKH), an inflammatory ocular disorder characterized by bilateral granulomatous panuveitis and a variety of extraocular manifestations, has been reported to be associated with various immune disorders but has not been linked to malignant lymphoma (ML). Case: We present here a case of VKH associated with a recurrence of ML. Observations: A 69-year-old man who initially had ML presented with a history of sudden bilateral visual acuity loss. Funduscopy showed papilloedema and serous retinal detachment in both eyes, and a diagnosis of VKH was reached soon thereafter. Chest X-ray and an abdominal computed tomography scan indicated the metastatic focus of the ML. A recurrence was suspected because the ML-associated soluble interleukin-2 receptor (sIL-2R) in the serum was highly elevated. Treatment successfully resolved both the ML and the VKH. The inflammatory activities of VKH and ML were found to correlate with the serum levels of sIL-2R. Conclusions: This case suggests an association between sIL-2R levels and disease activity in VKH and ML, and provides additional evidence that VKH can be induced by immune disorders caused by high sIL-2R levels in ML. (c) Japanese Ophthalmological Society 2005.