Managing Vogt–Koyanagi–Harada disease during pregnancy with steroid pulse therapy:A case report  

作　　者：Kyouhei Ueyama Toshiyuki Kakinuma Keisuke Mori Ayumi Hayashi Kaoru Kakinuma Rora Okamoto Ayaka Kaneko Kaoru Yanagida Nobuhiro Takeshima Michitaka Ohwada 

机构地区：[1]Department of Obstetrics and Gynecology,International University of Health and Welfare Hospital,Tochigi 329-2763,Nasushiobara,Japan [2]Department of Ophthalmology,International University of Health and Welfare Hospital,Tochigi 327-2763,Japan

出　　处：《World Journal of Clinical Cases》2024年第31期6493-6499,共7页世界临床病例杂志

摘　　要：BACKGROUND High-dose steroid administration is a common initial therapeutic approach for Vogt–Koyanagi–Harada disease(VKH).Nonetheless,administering substantial doses of steroids to pregnant women necessitates meticulous consideration due to the potential impacts on the mother and fetus.We present a case wherein steroid pulse therapy was administered to a patient who developed VKH during the late stages of pregnancy.CASE SUMMARY The patient was a 26-year-old nulliparous woman.At 33 weeks and 1 day of her pregnancy,she experienced a decline in visual acuity and noticed metamorphopsia in her left eye.Examination revealed bilateral serous retinal detachment,leading to VKH diagnosis.A collaborative effort involving the departments of ophthalmology,internal medicine,and neonatology was initiated.Steroid pulse therapy was administered at 34 weeks and 1 day of pregnancy under hospital supervision.Complications,such as threatened preterm labor and gestational diabetes,emerged,necessitating the initiation of oral ritodrine hydrochloride and insulin therapy.Then,serous retinal detachment was resolved,and visual acuity was restored.Labor pains initiated 32 days post-initiation of steroid pulse therapy(at 38 weeks and 4 days of gestation),culminating in a normal delivery.Mother and newborn experienced an uneventful puerperal course and were discharged from the hospital on the 5th day following delivery.CONCLUSION VKH management in pregnancy requires multidisciplinary coordination,emphasizing collaboration with ophthalmologists and specialists in internal medicine and neonatology.

关 键 词：Vogt-Koyanagi-Harada disease Gestational diabetes mellitus PREGNANCY Steroid pulse therapy Threatened preterm labor Case report 

分 类 号：R713.8[医药卫生—妇产科学]