Glucose Intolerance and
Vogt-Koyanagi-Harada Syndrome

R Sawhney, R Jain, S Kumar, BKS Pannu, S Sood
Department of Ophthalmology, Government
Medical College Hospital, Chandigarh, India

A 45-year-old Indian female presented with headache, dimness of vision of both eyes, and alopecia. Systemic and ocular investigations revealed her to have Vogt-Koyanagi-Harada syndrome with glucose intolerance that improved on receiving systemic corticoids.

In the patient described in this report, the follow up OGTT had a normal pattern. Jaggarao et al speculated that some processes alter the surface component both in melanocytes and pancreatic cells, leading to endocrine disturbance.⁵ However, there is currently no clear evidence that the cytotoxic cells recognise the same antigens in diabetes and VKH disease. It is now firmly believed that VKH syndrome results from a T cell mediated delayed hypersensitivity response to an antigen shared by melanocytes in the skin, meninges, inner ear, and the choroid.¹

Further studies and case reports may be needed to substantiate the mechanisms and association of glucose intolerance in VKH disease, and to understand whether or not the pathogenesis of the disease is autoimmune in nature.