Vogt-Koyanagi-Harada syndrome in a 4-year old child.

PURPOSE: We studied a case of severe bilateral Vogt-Koyanagi-Harada syndrome in a 4-year-old boy.

METHODS: We evaluated the patient's clinical course.

RESULTS: The patient had severe bilateral, nongranulomatous uveitis and mild uveitic glaucoma. Initial examination and laboratory evaluation failed to provide a diagnosis. The patient subsequently developed areas of vitiligo, alopecia, and poliosis, suggesting the diagnosis of Vogt-Koyanagi-Harada syndrome. This diagnosis was confirmed by the eventual development of bilateral neurosensory retinal detachments. Vision was lost despite aggressive therapy with corticosteroids and chlorambucil.

CONCLUSION: Although uncommon, Vogt-Koyanagi-Harada may affect young children, and may be severe.