Neurological manifestations of Behçet's disease: evaluation of 40 patients treated by cyclophosphamide.

Abstract

INTRODUCTION:

Neurological manifestations in Behçet's disease represent between 4 to 49% of systemic manifestations and remain, in the long term, the leading cause of morbidity and mortality.

METHODS:

Retrospective series of 40 severe Neurobehçet cases fulfilling the International Study Group criteria for Behçet's disease were consecutively recruited over a period from June 2004 to December 2010. All patients had clinical and ophthalmologic examinations; they underwent laboratory and imaging investigations. They received corticosteroids and cyclophosphamide as initial bolus of 600 mg/m(2) of BSA in the 1st, 2nd, 4th, 6th and 8th day followed by a bolus of 600 mg/m(2) BSA every 2 months for 2 years. Antithrombotic therapy was given to patients with cerebral deep venous thrombosis. Patient follow-up and tolerance to treatment were analyzed.

RESULTS:

The average age at diagnosis was 34±13 years, with a sex-ratio of 1.78. The clinical presentation was dominated by the meningoencephalitis in 48.8% of cases, cerebral deep venous thrombosis in 43.6% of cases and myelopathy in 7.7% of cases. The 40 patients receiving cyclophosphamide bolus, despite two aggravated cases, evolved positively with clinical improvement and good tolerance.

CONCLUSION:

The demographic and clinical aspects of our series are similar to those reported in the literature. In contrast to previously reported cases of a poor prognosis in severe neurobehçet's disease, our study suggests that immediate and aggressive treatment by cyclophosphamide may ameliorate the prognosis. However, a multicenter study is needed to confirm the possible efficacy of cyclophosphamide and further assess the long-term tolerance.

• Authors: E H Ait Ben Haddou, F Imounan, W Regragui, O Mouti, N Benchakroune, R Abouqal, A Benomar, M Yahyaoui
• Journal: Revue neurologique (Rev Neurol (Paris)) Vol. 168 Issue 4 Pg. 344-9 (Apr 2012) ISSN: 0035-3787 [Print] France
• PMID: 22136880 (Publication Type: Evaluation Study, Journal Article)
• Copyright: Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Chemical References

• Anti-Inflammatory Agents
• Cyclophosphamide

Topics

• Adolescent
• Adult
• Aged
• Anti-Inflammatory Agents (therapeutic use)
• Behcet Syndrome (complications, drug therapy, epidemiology, psychology)
• Cyclophosphamide (therapeutic use)
• Disease Progression
• Female
• Humans
• Male
• Middle Aged
• Nervous System Diseases (drug therapy, epidemiology, etiology)
• Retrospective Studies
• Treatment Outcome
• Young Adult