Abstract
Central nervous system involvement is a rare and serious complication of Behçet's disease (BD). Herein, we describe a patient with an atypical central lesion, who experienced progressive hypesthesia of the right arm and sensory loss of the trigeminal nerve together with intense headache. A repeated biopsy was necessary to conclusively establish the diagnosis of BD. Therapy with infusions of infliximab led to a remarkable full remission. TNFα-blocking therapy was successfully replaced by azathioprine. The present well-illustrated case demonstrates the difficulty of establishing the diagnosis of BD with central nervous system involvement, the dramatic benefit of short given TNF-α-blocking agent, and the long-term remission with azathioprin.
MeSH terms
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Adult
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Antibodies, Monoclonal / administration & dosage*
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Azathioprine / administration & dosage
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Behcet Syndrome / complications
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Behcet Syndrome / diagnosis
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Behcet Syndrome / drug therapy*
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Behcet Syndrome / immunology
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Biopsy
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Central Nervous System Diseases / drug therapy*
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Central Nervous System Diseases / etiology
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Central Nervous System Diseases / immunology
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Central Nervous System Diseases / physiopathology
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Drug Administration Schedule
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Drug Substitution
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Female
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Headache / drug therapy
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Headache / etiology
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Headache / immunology
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Humans
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Hypesthesia / drug therapy
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Hypesthesia / immunology
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Hypesthesia / physiopathology
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Immunohistochemistry
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Immunosuppressive Agents / administration & dosage*
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Infliximab
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Magnetic Resonance Imaging
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Remission Induction
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Treatment Outcome
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Trigeminal Nerve / drug effects
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Trigeminal Nerve / physiopathology
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Tumor Necrosis Factor-alpha / antagonists & inhibitors
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Upper Extremity / innervation*
Substances
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Antibodies, Monoclonal
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Immunosuppressive Agents
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Tumor Necrosis Factor-alpha
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Infliximab
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Azathioprine