Vogt–Koyanagi–Harada-like Disease following Yellow Fever Vaccination

ABSTRACT

Purpose: To report the manifestation of Vogt–Koyanagi–Harada-like disease (VKH) following yellow fever vaccination.

Methods: Case report.

Results: A 34-year-old immunocompetent male had tinnitus, headache, and decreased vision after a booster dose of yellow fever vaccine. Visual acuity was 20/100 in the right eye and 20/80 in the left, with serous retinal detachment (SRD) and choroidal thickening identified on clinical examination and multimodal imaging. Lumbar puncture revealed pleocytosis and an increased protein content, but extensive investigations ruled out infectious/neurological diseases. Pulse intravenous methylprednisolone was given, followed by a tapering regimen of high-dose oral prednisone. Azathioprine was started early, 3 weeks after initiation of oral steroids. Intraocular inflammation and SRD rapidly resolved, with visual acuity reaching 20/20 in both eyes, after 3 weeks. No recurrence of intraocular inflammation or sign of depigmentation was so far noticed, at 2 years of follow-up.

Conclusion: Yellow fever vaccine may be a possible trigger for VKH.

Keywords:

• Choroiditis
• uveitis
• Vogt–Koyanagi–Harada disease
• yellow fever vaccine

DECLARATION OF INTEREST

All authors declare no competing interests.

Additional information

Funding

Prof. Vasconcelos-Santos was supported, in part, by Conselho Nacional de Desenvolvimento Científico e Tecnológico [CNPq] (Bolsa de produtividade em pesquisa 313293/2018-0) and by a grant from MCTI/FINEP/FNDCT (24754-1/2016).