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Khieu C, Chanthan D. Novel approach to Behçet's disease in the era of biologic agents. Curr Opin Ophthalmol 2023; 34:535-542. [PMID: 37610430 DOI: 10.1097/icu.0000000000000992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
PURPOSE This review aims to provide better understanding of modern modalities to investigate ocular symptoms of Behçet's disease in order to achieve appropriate management protocols and reduce irreversible visual loss. RELEVANT FINDINGS Current methods of diagnosing intraocular involvement in Behçet's disease gives clue to early diagnosis. In addition to standard ocular examination and fluorescein angiography, new noninvasive methods include ocular coherence tomography (OCT) and OCT angiography provide early detection of macular and retinal involvement that can be treated early to improve the prognosis. SUMMARY Over the last decade, new multimodal imagings are becoming more accessible; therefore, rapid diagnosis can be made. In addition to newer approved biologic agents, ocular Behçet's disease is seen to be in better controlled with fewer complications.
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Affiliation(s)
- Chansathya Khieu
- Department of Ophthalmology, Khmer-Soviet Friendship Hospital, Phnom Penh, Cambodia
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Taurone S, Spoletini M, Ralli M, Gobbi P, Artico M, Imre L, Czakò C, Kovàcs I, Greco A, Micera A. Ocular mucous membrane pemphigoid: a review. Immunol Res 2019; 67:280-289. [DOI: 10.1007/s12026-019-09087-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Implication of B lymphocytes in the pathogenesis of ANCA-associated vasculitides. Autoimmun Rev 2015; 14:996-1004. [DOI: 10.1016/j.autrev.2015.06.008] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Accepted: 06/29/2015] [Indexed: 12/23/2022]
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Wakefield D. Does Cyclophosphamide Still Have a Role in the Treatment of Severe Inflammatory Eye Disease? Ocul Immunol Inflamm 2013; 22:306-10. [DOI: 10.3109/09273948.2013.854395] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Systemic treatments for noninfectious vitreous inflammation. Mediators Inflamm 2013; 2013:515312. [PMID: 24347829 PMCID: PMC3853923 DOI: 10.1155/2013/515312] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2013] [Accepted: 09/26/2013] [Indexed: 12/14/2022] Open
Abstract
Vitreous inflammation, or vitritis, may result from many causes, including both infectious and noninfectious, including rheumatologic and autoimmune processes. Vitritis is commonly vision threatening and has serious sequelae. Treatment is frequently challenging, but, today, there are multiple methods of systemic treatment for vitritis. These categories include corticosteroids, antimetabolites, alkylating agents, T-cell inhibitors/calcineurin inhibitors, and biologic agents. These treatment categories were reviewed last year, but, even over the course of just a year, many therapies have made progress, as we have learned more about their indications and efficacy. We discuss here discoveries made over the past year on both existing and new drugs, as well as reviewing mechanisms of action, clinical dosages, specific conditions that are treated, adverse effects, and usual course of treatment for each class of therapy.
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Denniston AK, Dick AD. Systemic therapies for inflammatory eye disease: past, present and future. BMC Ophthalmol 2013; 13:18. [PMID: 23617902 PMCID: PMC3639939 DOI: 10.1186/1471-2415-13-18] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Accepted: 02/04/2013] [Indexed: 12/15/2022] Open
Abstract
In this review we consider the current evidence base for treatments in inflammatory eye disease, and in particular uveitis, from a historical perspective. We consider the challenges that have traditionally hindered progress in inflammatory eye disease including small target populations, heterogeneous disease groups, poorly defined phenotypes, diagnostic inconsistency, subjective outcome measures, specific issues around visual acuity as an outcome measure and low commercial interest. Strategies to address these issues are considered de novo and with reference to recent advances outside of ophthalmology and highlight the promise for ocular inflammation. Progress in these specialties has included the development of thriving clinical-trial cultures, public-private partnerships, pathogenetic- and structure-led drug design, efficient drug development pipelines, and biomarker-defined treatment protocols enabling personalization of medicine. Although there are challenges, these are exciting opportunities as we seek to develop safe and effective treatments for patients with inflammatory eye disease.
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Affiliation(s)
- Alastair K Denniston
- Ophthalmology Department, University Hospitals Birmingham NHS Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B15 2WB, UK.
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Khan IJ, Barry RJ, Amissah-Arthur KN, Carruthers D, Elamanchi SR, Situnayake D, Murray PI, Denniston AK, Rauz S. Ten-year experience of pulsed intravenous cyclophosphamide and methylprednisolone protocol (PICM protocol) in severe ocular inflammatory disease. Br J Ophthalmol 2012. [DOI: 10.1136/bjophthalmol-2012-302130] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Systemic treatment of vitreous inflammation. Mediators Inflamm 2012; 2012:936721. [PMID: 23028205 PMCID: PMC3457724 DOI: 10.1155/2012/936721] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Accepted: 08/21/2012] [Indexed: 02/07/2023] Open
Abstract
Non infectious vitreous inflammation is often vision threatening and can be associated with potentially life-threatening systemic conditions. Treatment is often challenging as it involves systemic medications that can be associated with adverse effects. The classes of drugs are ever expanding and include corticosteroids, antimetabolites, alkylating agents, T-cell and calcineurin agents, biologic agents, and interferons. Each class of systemic therapy for non-infectious vitreous inflammation is reviewed. We discuss the mechanisms of action, usual clinical dosages, the specific conditions that are treated, the adverse effects, and usual course of treatment for each class of therapy.
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Schreiber BE, Noor N, Juli CF, Haskard DO. Resolution of Behçet's Syndrome Associated Pulmonary Arterial Aneurysms with Infliximab. Semin Arthritis Rheum 2011; 41:482-7. [DOI: 10.1016/j.semarthrit.2011.02.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Revised: 02/25/2011] [Accepted: 02/28/2011] [Indexed: 11/27/2022]
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Durrani K, Zakka FR, Ahmed M, Memon M, Siddique SS, Foster CS. Systemic Therapy With Conventional and Novel Immunomodulatory Agents for Ocular Inflammatory Disease. Surv Ophthalmol 2011; 56:474-510. [DOI: 10.1016/j.survophthal.2011.05.003] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2010] [Revised: 05/18/2011] [Accepted: 05/24/2011] [Indexed: 12/19/2022]
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Mieler WF. Closed Vitrectomy and Chronic Uveitis. Semin Ophthalmol 2009. [DOI: 10.3109/08820538909060127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Larsson H, Bengtsson-Stigmar E. Behçet's disease and close contact with pigs. ACTA MEDICA SCANDINAVICA 2009; 216:541-3. [PMID: 6524459 DOI: 10.1111/j.0954-6820.1984.tb05044.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Six male patients out of seven with Behçet's disease were found to have a very similar and close contact with pigs and pork. These six cases are reported and we ask the question whether the contacts with pigs are just coincidental findings or whether an external agent, e.g. a virus, could be forwarded to man from pigs and pork. Immune complex associated vasculitis is described e.g. in patients with hepatitis B and the same mechanisms might be operating in patients with Behçet's disease.
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Affiliation(s)
- Douglas A Jabs
- Department of Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.
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Durrani K, Papaliodis GN, Foster CS. Pulse IV cyclophosphamide in ocular inflammatory disease. Ophthalmology 2004; 111:960-5. [PMID: 15121375 DOI: 10.1016/j.ophtha.2003.08.034] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2002] [Accepted: 08/04/2003] [Indexed: 10/26/2022] Open
Abstract
PURPOSE To assess the efficacy and short-term safety of appropriately monitored pulse IV cyclophosphamide therapy in the treatment of patients with severe or treatment-resistant autoimmune ocular inflammatory disease. DESIGN Retrospective noncomparative interventional case series. PARTICIPANTS Thirty-eight patients with severe or recalcitrant ocular inflammation of diverse etiologies. METHODS Charts of patients seen on the Ocular Immunology & Uveitis Service at the Massachusetts Eye & Ear Infirmary were reviewed. Thirty-eight consecutive patients treated with pulse IV cyclophosphamide between January 1995 and March 2002 were analyzed. MAIN OUTCOME MEASURES The control of inflammation, steroid-sparing effect, visual acuity, and adverse reactions. RESULTS A positive response to treatment occurred in 68% of patients during the study period, with 55% achieving complete quiescence. A steroid-sparing effect was achieved in all patients previously on systemic steroid, allowing successful discontinuation of the drug in 41%. Visual acuity was maintained in 66% and improved in 21% of involved eyes. The most common side effects observed were fatigue (63%), nausea (32%), and headache (22%). None required a permanent discontinuation of therapy. CONCLUSIONS Pulse IV cyclophosphamide is an effective therapeutic modality in patients with severe or treatment-resistant ocular inflammatory disease.
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Affiliation(s)
- Khayyam Durrani
- Immunology & Uveitis Service, Department of Ophthalmology, Massachusetts Eye & Ear Infirmary, Boston, Massachusetts 02114, USA
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Jabs DA, Rosenbaum JT, Foster CS, Holland GN, Jaffe GJ, Louie JS, Nussenblatt RB, Stiehm ER, Tessler H, Van Gelder RN, Whitcup SM, Yocum D. Guidelines for the use of immunosuppressive drugs in patients with ocular inflammatory disorders: recommendations of an expert panel. Am J Ophthalmol 2000; 130:492-513. [PMID: 11024423 DOI: 10.1016/s0002-9394(00)00659-0] [Citation(s) in RCA: 640] [Impact Index Per Article: 26.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE To provide recommendations for the use of immunosuppressive drugs in the treatment of patients with ocular inflammatory disorders. PARTICIPANTS A 12-person panel of physicians with expertise in ophthalmologic, pediatric, and rheumatologic disease, in research, and in the use of immunosuppressive drugs in patient care. EVIDENCE Published clinical study results. Recommendations were rated according to the quality and strength of available evidence. PROCESS The panel was convened in September of 1999 and met regularly through May 2000. Subgroups of the panel summarized and presented available information on specific topics to the full panel; recommendations and ratings were determined by group consensus. CONCLUSIONS Although corticosteroids represent one of the mainstays in the management of patients with ocular inflammation, in many patients, the severity of the disease, the presence of corticosteroid side effects, or the requirement for doses of systemic corticosteroids highly likely to result in corticosteroid complications supports the rationale for immunosuppressive drugs (for example, antimetabolites, T-cell inhibitors, and alkylating agents) being used in the management of these patients. Because of the potential for side effects, treatment must be individualized and regular monitoring performed. With careful use of immunosuppressive drugs for treatment of ocular inflammatory disorders, many patients will benefit from them either with better control of the ocular inflammation or with a decrease in corticosteroid side effects.
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Affiliation(s)
- D A Jabs
- Wilmer Eye Institute and the Departments of Ophthalmology and Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
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Chavis PS, Antonios SR, Tabbara KF. Cyclosporine effects on optic nerve and retinal vasculitis in Behçet's disease. Doc Ophthalmol 1992; 80:133-42. [PMID: 1425128 DOI: 10.1007/bf00161239] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
In a prospective, open clinical trial, we studied long-term effects of cyclosporine (CsA) on the optic nerve and retinal vasculitis in 14 Behçet's disease patients. Patients were treated with CsA and corticosteroids for a mean period of 42 months, with a range of 36 to 52 months. They received an initial CsA dosage of 7 mg/kg/day for three days, followed by 5 mg/kg/day, and prednisone 1 mg/kg/day for three to five days, tapered to 0.4 mg/kg/day. CsA was tapered when clinical response was noted. Improvement occurred in visual acuity and visual field defects secondary to papillitis, optic neuritis, macular neuroretinitis, and retinal phlebitis, but not with retinal arteritis. Despite a 12/14 (85%) exacerbation rate, no permanent liver or renal lab tests abnormalities were noted. Intermittent, low-dose CsA therapy may be considered in treatment of acute retinal and optic nerve vasculitis assisted with Behçet's disease.
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Affiliation(s)
- P S Chavis
- King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
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Ahmed AR, Hombal SM. Cyclophosphamide (Cytoxan). A review on relevant pharmacology and clinical uses. J Am Acad Dermatol 1984; 11:1115-26. [PMID: 6392368 DOI: 10.1016/s0190-9622(84)80193-0] [Citation(s) in RCA: 126] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Cyclophosphamide (Cytoxan; Cy) is an alkylating agent with cytotoxic and immunosuppressive activities. The parent compound is inactive in vitro and exerts its biologic activity through metabolites, mainly phosphoramide mustard generated by hepatic microsomal enzymes. The exact mode of cytotoxic and immunosuppressive action of Cy at cellular level is not completely understood. Myelosuppression, hemorrhagic cystitis, alopecia, and gonadal damage are the main toxic effects. Available data suggest that Cy has carcinogenic potential in humans. Cy is widely used for cancer chemotherapy. As an immunosuppressive agent, it is successfully used in certain nonmalignant diseases in which autoimmune phenomena are established or suspected in the pathogenesis of the disease. It is the drug of choice in Wegener's granulomatosis. Extensive efforts are being made to synthesize Cy analogues with greater selective cytotoxic and immunosuppressive activity. Ifosfamide, a Cy analogue, appears to possess similar cytotoxic activity with less myelosuppression. Further research will help in synthesizing a Cy analogue with specific pharmacologic activity and reduced or absent harmful effects.
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Abstract
Behçet's disease is a multisystem disease featuring mucocutaneous, ocular, intestinal, articular, vascular, urogenital, and neurologic involvement. While classically intermittent in its manifestations, the disease can stabilize and become chronic in a given organ system. The diagnosis of Behçet's disease is based on clinical criteria. Recurrent aphthous ulcerations in the mouth, skin lesions, eye lesions, and genital ulcerations must be present during the course of the disease for a diagnosis of Behçet's disease to be made unequivocally. A nonspecific skin hyperreactivity called pathergy is said to be helpful in the diagnosis. There are no pathognomonic laboratory findings, but biopsy usually shows a venulitis. The pathogenesis of the disease is unknown. No virus has been satisfactorily isolated to date. There is evidence of an increased frequency of HLA-B5 and HLA-B12. Humoral and cellular immunity seem to play a major part in the pathogenesis of the various manifestations of the disease. The treatment of Behçet's disease is difficult to evaluate because of the many spontaneous exacerbations and remissions during the clinical course of the disease. Topical corticosteroids for orogenital ulcers and ocular inflammation are helpful. Intralesional injections for affected joints and retrobulbar tissues are useful in some cases. Systemic corticosteroids have appeared to be helpful for all manifestations of the disease. It is customary to use 60 mg of prednisone by mouth daily during acute exacerbations, then to taper as the condition improves. Chlorambucil has been shown to be safe and effective for various manifestations of Behçet's disease; often it is used in combination with corticosteroids.(ABSTRACT TRUNCATED AT 250 WORDS)
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Kovarsky J. Clinical pharmacology and toxicology of cyclophosphamide: emphasis on use in rheumatic diseases. Semin Arthritis Rheum 1983; 12:359-72. [PMID: 6348951 DOI: 10.1016/0049-0172(83)90016-1] [Citation(s) in RCA: 58] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Abstract
Behçet's disease is characterized by three primary components: iridocyclitis (historically with hypopyon), aphthous lesions in the mouth, and ulceration of the genitalia. Erythema nodosum, arthropathy and thrombophlebitis often accompany these manifestations, but the ocular symptoms may be the most important and serious manifestations of the disease. Central nervous system involvement, most often due to necrotizing vasculitis, may be the most protean manifestation of the disease, leading to death. The frequency of ocular manifestations is 70-85% in patients with the disease; the underlying disease mechanism in all organ systems is an occlusive vasculitis. Although the most common ocular symptom is that of anterior uveitis, often with hypopyon as a very late sign, the presence of necrotizing retinal vascular lesions is well known and often obscured by the severity of the anterior reaction. Definitions, incidence, clinical characteristics, differential diagnosis, and management of Behçet's ocular disease are discussed, as are the interrelationships of the different organ manifestations. The ophthalmologist should be familiar with the full spectrum of disease presentation since he or she may be the first physician to encounter the Behçet's patient.
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Fukutani K, Ishida H, Shinohara M, Minowada S, Niijima T, Hijikata K, Izawa Y. Suppression of spermatogenesis in patients with Behçet's disease treated with cyclophosphamide and colchicine. Fertil Steril 1981; 36:76-80. [PMID: 6788612 DOI: 10.1016/s0015-0282(16)45622-0] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Reproductive function was studied in 31 adult male patients with Behçet's disease during treatment with cyclophosphamide and/or colchicine for 1 to 64 months. Semen was obtained from 27 patients. Azoospermia or severe oligospermia was found in 13 of 17 patients receiving cyclophosphamide with or without colchicine, whereas the sperm count was almost normal in six patients treated with colchicine alone and in four patients receiving neither drug (control patients). Blood samples were available for 31 patients. The mean follicle-stimulating hormone level among 12 cyclophosphamide-treated patients was significantly higher than that of 6 colchicine-treated patients and 6 control patients. These results indicate that cyclophosphamide impairs spermatogenesis in adult men, whereas colchicine does not.
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de Merieux P, Spitler LE, Paulus HE. Treatment of Behcet's syndrome with levamisole. ARTHRITIS AND RHEUMATISM 1981; 24:64-70. [PMID: 7008801 DOI: 10.1002/art.1780240111] [Citation(s) in RCA: 40] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The clinical response to levamisole in 11 patients with complete Behcet's syndrome was reviewed. Nine patients responded, 3 completely and 6 partially, with reduction in the number and severity of buccal and genital lesions. In 3 patients each, ocular inflammation and gastrointestinal involvement responded to levamisole, and in 1 patient neurologic status improved. Levamisole was purposely discontinued in 3 patients to assess its true role in disease control. Each patient experienced a flare. Reintroduction of therapy controlled the flare in all cases, although 1 patient subsequently relapsed while continuing therapy. Two patients failed to respond. Side effects necessitated permanent discontinuation of the drug in 2 respondent patients, but in no case did neutropenia or agranulocytosis develop. These preliminary results suggest that levamisole may be useful in the therapy of the various manifestations of Behcet's syndrome and that a controlled prospective study is indicated.
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Scarlett JA, Kistner ML, Yang LC. Behçet's syndrome. Report of a case associated with pericardial effusion and cryoglobulinemia treated with indomethacin. Am J Med 1979; 66:146-8. [PMID: 420242 DOI: 10.1016/0002-9343(79)90506-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
A patient with Behçet's syndrome manifested by optic atrophy, purulent conjunctivitis and orogenital ulcerations presented with a high fever and pericardial effusion. A mixed cryoglobulinemia (immunoglobulin A (IgA)-immunoglobulin G (IgG)) was observed. Treatment with indomethacin resulted in rapid defervescence, resolution of the pericardial effusion and the orogenital ulcerations, and disappearance of the cryoglobulinemia. Discontinuation of indomethacin therapy was followed by a recurrence of the oral and genital ulcerations that responded promptly to the reinstitution of indomethacin treatment.
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Abstract
Two patients with Behĉet's disease are reported, both of whom had aneurysms of peripheral arteries. In one the aneurysms were multiple. The aneurysm was replaced with a Terylene prosthesis in one patient, and in the other an autogenous vein bypass was used. In each case a further aneurysm developed adjacent to the vascular anastomosis. Severe ischaemia of the affected limbs subsequently developed in both patients.
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Hornstein OP. [Inflammatory and systemic reactions of the mouth mucosa]. ARCHIVES OF OTO-RHINO-LARYNGOLOGY 1976; 213:287-331. [PMID: 830105 DOI: 10.1007/bf00462779] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The field of oral medicine is fundamental to the practice of general medicine as well as dentistry, oral surgery, and other special fields of medicine concerned with diseases of organs beneath the oral cavity. Disorders of the oral mucosa may reflect many dermal and internal diseases, and may focus the physician's diagnostic attention to systemic pathological conditions which otherwise could be misdiagnosed. As to their morphological appearance, however, the oral mucosa shows other forms of reactivity than the skin. When the dermal and oral manifestations of many skin diseases are compared the influence of distinct local factors on the intraoral clinical picture becomes evident. This comparative view, as well as the dermatologist's practical experience that many dermatoses either spread to, or even are restricted to the oral mucosa, may explain why most dermatologists are very interested in oral diagnosis. In this report, the interdisciplinary view and some aspects of clinical stomatology are stressed which are of actual interest in oral diagnosis and therapy. The following topics are dealt with: Diseases with aphthous lesions, Allergic reactions to drugs, Pemphigus and pemphigoid disorders, Oral infections by Candida albicans, Melkersson-Rosenthal syndrome, Lingual anomalies of different types, Leukoplakias.
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Affiliation(s)
- O P Hornstein
- Dermatologische Universitäts Klinik, Erlangen, Bundesrepublik Deutschland
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Cooper DA, Penny R. Behcet's syndrome: clinical, immunological and therapeutic evaluation of 17 patients. AUSTRALIAN AND NEW ZEALAND JOURNAL OF MEDICINE 1974; 4:585-96. [PMID: 4533949 DOI: 10.1111/j.1445-5994.1974.tb03243.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Godfrey WA, Epstein WV, O'Connor GR, Kimura SJ, Hogan MJ, Nozik RA. The use of chlorambucil in intractable idiopathic uveitis. Am J Ophthalmol 1974; 78:415-28. [PMID: 4472398 DOI: 10.1016/0002-9394(74)90229-3] [Citation(s) in RCA: 65] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Marquardt JL, Snyderman R, Oppenheim JJ. Depression of lymphocyte transformation and exacerbation of Behcet's syndrome by ingestion of english walnuts. Cell Immunol 1973; 9:263-72. [PMID: 4584788 DOI: 10.1016/0008-8749(73)90077-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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Schneider H. [Symptomatology of Behçet's disease (author's transl)]. ARCHIV FUR PSYCHIATRIE UND NERVENKRANKHEITEN 1973; 217:247-58. [PMID: 4742436 DOI: 10.1007/bf02552838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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