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Matsumoto H, Yashiro-Furuya M, Fujita Y, Asano T, Mori T, Sato S, Temmoku J, Matsuoka N, Watanabe H, Suzuki E, Migita K. Vascular Behcet's Disease Preceded by Fever of Unknown Origin: Usefulness of Ultrasonography for the Detection of Large-Vessel Vasculitis. TOHOKU J EXP MED 2021; 255:163-169. [PMID: 34707017 DOI: 10.1620/tjem.255.163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Behcet's disease is a systemic vasculitis characterized by oral and genital ulcers, erythema nodosum, and ocular involvement. Fever of unknown origin is a relatively rare event in Behcet's disease. We present the case of a 17-year-old male patient who suffered from prolonged fever for two months. The patient tested positive for HLA-B52 and levels of acute phase reactants were elevated. He complained of sore throat and neck pain that were evaluated by cervical ultrasonography, which revealed thickening of the carotid arterial wall and narrowing of the vessel lumen. The patient was diagnosed with vascular Behcet's disease and treated with glucocorticoid, which improved the clinical symptoms and thickening of the carotid arterial wall as detected by color duplex ultrasonography. Since vascular Behcet's disease may lead to morbidity and mortality, we suggest the early use of ultrasonography to help detect medium/large-vessel vasculitis. Prolonged fever in patients with Behcet's disease should be promptly evaluated for vascular involvement.
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Affiliation(s)
- Haruki Matsumoto
- Department of Rheumatology, Fukushima Medical University School of Medicine
| | | | - Yuya Fujita
- Department of Rheumatology, Fukushima Medical University School of Medicine
| | - Tomoyuki Asano
- Department of Rheumatology, Fukushima Medical University School of Medicine
| | - Tatsuhiko Mori
- Department of Dermatology, Fukushima Medical University School of Medicine
| | - Shuzo Sato
- Department of Rheumatology, Fukushima Medical University School of Medicine
| | - Jumpei Temmoku
- Department of Rheumatology, Fukushima Medical University School of Medicine
| | - Naoki Matsuoka
- Department of Rheumatology, Fukushima Medical University School of Medicine
| | - Hiroshi Watanabe
- Department of Rheumatology, Fukushima Medical University School of Medicine
| | - Eiji Suzuki
- Department of Rheumatology, Ohta Nishinouchi General Hospital Foundation
| | - Kiyoshi Migita
- Department of Rheumatology, Fukushima Medical University School of Medicine
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Couselo-Rodríguez C, Hogeboom-Gimeno AG, Puerta-Peña M, Gallardo-Gallego R, Garrido-Ruíz MC, Rodríguez-Peralto JL. The utility of orcein and elastic Verhoeff-Van Gieson stain to demonstrate phlebitis in nodular cutaneous lesions of Behçet disease. Int J Dermatol 2021; 61:e270-e272. [PMID: 34363607 DOI: 10.1111/ijd.15830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/08/2021] [Accepted: 07/20/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Carmen Couselo-Rodríguez
- Department of Dermatology, Pontevedra University Hospital, Pontevedra, Spain.,DIPO Research Group, Galicia Sur Health Research Institute, SERGAS-UVIGO., Pontevedra, Spain
| | - Adriana G Hogeboom-Gimeno
- Department of Pathology, 12 de Octubre University hospital, Complutense University of Madrid, Investigation institute I+12, CIBERONC, Madrid, Spain
| | - Mario Puerta-Peña
- Department of Dermatology, 12 de Octubre University hospital, Complutense University of Madrid, Investigation institute I+12, CIBERONC, Madrid, Spain
| | - Rubén Gallardo-Gallego
- Department of Pathology, 12 de Octubre University hospital, Complutense University of Madrid, Investigation institute I+12, CIBERONC, Madrid, Spain
| | - María C Garrido-Ruíz
- Department of Pathology, 12 de Octubre University hospital, Complutense University of Madrid, Investigation institute I+12, CIBERONC, Madrid, Spain
| | - Jose L Rodríguez-Peralto
- Department of Pathology, 12 de Octubre University hospital, Complutense University of Madrid, Investigation institute I+12, CIBERONC, Madrid, Spain
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Yin H, Song Y, Zheng M, Han J, Tang J. Behcet's Disease With Cerebral Artery Infarction Caused by Cerebral Arteritis as an Early Symptom Only With Elevated Interleukin-8. Front Neurol 2019; 10:1102. [PMID: 31695669 PMCID: PMC6817676 DOI: 10.3389/fneur.2019.01102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 10/01/2019] [Indexed: 12/20/2022] Open
Abstract
Background: Behcet's disease (BD) is multi-systemic vasculitis, which generally is repeated oral and genital ulcerations as well as ocular and skin lesions. Today, the pathogenesis of BD remains mostly unknown. It is also suggested that the disease is probably related to autoinflammatory and autoimmune disorders, and innate immunity damages were perceived as key in its pathologic process. Only 5% of BD patients have neurological involvement, and it usually occurs in 4–6 years after the initial symptoms. Early onset of neurological impairment makes it difficult to diagnose and treat definitely. Case Presentation: A 38-year-old man was admitted to our hospital with numbness and weakness of the left extremities. Diffusion magnetic resonance imaging (MRI) revealed focal infarction in the posterior limb of the internal capsule. Skin pathology suggested small vessel vasculitis, and high-resolution MRI revealed intracranial arteritis. The patient had a negative skin pathery test and then developed a scar at the venous puncture site at the early stage of disease. Laboratory examination showed that interleukin 8 (IL-8) increased. The patient was treated with an immunosuppressive agent including mycophenolate mofetil, hydroxychloroquine, and colchicine. All symptoms were alleviated after half a year's treatment. There was neither stroke nor recurrence of oral ulcer thereafter. Conclusion: This case demonstrates that neurological involvement might be an early symptom of BD. IL-8 could act as a novel target for the treatment of BD theoretically and probably play a key role in disease recovery.
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Affiliation(s)
- Hao Yin
- Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China.,The First Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Yun Song
- Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China.,The First Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Meimei Zheng
- Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China.,The First Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Ju Han
- Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China.,The First Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Jiyou Tang
- Shandong Provincial Qianfoshan Hospital, Shandong University, Jinan, China.,The First Affiliated Hospital of Shandong First Medical University, Jinan, China
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The Evaluation of the Relationship between sTREM-1, VEGF-B, and VEGF Gene Expression Levels with Disease Activity of Behçet's Patients. DISEASE MARKERS 2018; 2018:2649392. [PMID: 30420902 PMCID: PMC6215573 DOI: 10.1155/2018/2649392] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 08/10/2018] [Accepted: 08/28/2018] [Indexed: 11/23/2022]
Abstract
Background There is no specific marker that shows the disease activity in Behçet's disease. Aim In this study, we aimed to investigate VEGF-B and VEGF gene expressions and sTREM-1 levels in association with the activation of Behçet's disease. Study Design Case-control study. Methods Clinical features of patients who applied in the rheumatology clinic and were diagnosed with BD according to the international working group's criteria were investigated. 30 healthy volunteers and 30 patients in the active period according to the EBDCAF scoring were studied. VEGF-B and VEGF gene expressions and sTREM-1 levels were studied in the serum samples of the patients and the control subjects. Results The VEGF-B expressions and sTREM-1 levels were higher in the BD than those in the healthy group, but this difference did not reach statistical significance. VEGF gene expression was statistically significant (p = 0.008). Behçet's disease patients with oral aphthae, genital ulcer, eye, joint, vascular, skin, and neurological involvement were analyzed separately as subgroups. We find that VEGF gene expression level of Behçet's disease patients with joint involvement (arthritis/arthralgia) and also VEGF-B and VEGF gene expression of Behçet's disease with vascular involvement (DVT/thrombophlebitis) were significantly higher (p = 0.035, p = 0.021). Each subgroup was analyzed with the control group. We determined that VEGF gene expression in all subgroups was significantly higher than that in the control group. At the same time, VEGF-B levels of patients with genital ulcer and vascular involvement (DVT/thrombophlebitis) were significantly higher than those in the control group. Conclusion VEGF-B and VEGF gene expressions can be activity indicators for BD. In addition, this study shows that new treatment options should be explored for Behçet's disease patients with joint and vascular involvement. In the following years, new treatment methods are needed to investigate for revealing the role of the etiopathogenesis of BD and the activation and prognosis of VEGF by examining this study and providing much more participation. In our study group, the sTREM-1 levels were high but the results did not reach statistical significance. More studies are needed with larger groups in order the highlight the exact role of STREM-1 in Behçet's disease.
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Marta M, Santos E, Coutinho E, Silva AM, Correia J, Vasconcelos C, Giovannoni G. The role of infections in Behçet disease and neuro-Behçet syndrome. Autoimmun Rev 2015; 14:609-15. [DOI: 10.1016/j.autrev.2015.02.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 02/25/2015] [Indexed: 11/26/2022]
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Wang LH, Wang WM, Hsu SM, Lin SH, Shieh CC. Risk of Overall and Site-specific Cancers in Behçet Disease: A Nationwide Population-based Study in Taiwan. J Rheumatol 2015; 42:879-84. [DOI: 10.3899/jrheum.140770] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2015] [Indexed: 01/21/2023]
Abstract
Objective.The relationship between autoimmune disease and cancer is complex while large-scale epidemiological studies of cancer risk in Behçet disease (BD) have not been reported. Therefore, we conducted a nationwide population-based cohort study.Methods.By using the National Health Insurance Research Database of 23 million people in Taiwan, we identified 1314 new patients with BD without previous cancer from 2000–2009 as a cohort. Standardized incidence ratios (SIR) of overall and site-specific cancers in patients with BD in comparison with the general population were calculated from 2000–2011.Results.Among the 1314 patients with BD, 30 developed cancers (9 men and 21 women). In overall cancer risk analysis, patients with BD had a higher risk (SIR 1.5, 95% CI 1.03–2.11). Among them, female patients with BD (SIR 1.8, 95% CI 1.14–2.7), but not male patients with BD (SIR 1.08, 95% CI 0.53–1.98), have a higher risk of overall cancer. In site-specific cancer risk analysis, patients with BD had a higher risk of non-Hodgkin lymphoma (SIR 8.3, 95% CI 2.1–22.7), hematological malignancy (SIR 4.2, 95% CI 1.3–10.2), and female breast cancer (SIR 2.2, 95% CI 1.004–4.1). The cancer risk was highest within the first-year followup (SIR 2.7, 95% CI 1.3–5.1), with 75% of the hematological malignancies found within the first year.Conclusion.This nationwide cohort study of cancer risk in patients with BD provides important information about the relationship between BD and malignancies. The results can be useful for cancer surveys in the future.
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Abstract
PURPOSE OF REVIEW Large vessel vasculitis occurs in a subgroup of patients with Behçet's disease who are at high risk for disease-related morbidity and mortality. Recognition of patients at risk, early detection of vasculitis, and aggressive treatment are essential for optimal care of these patients. We review the expanding knowledge on large vessel problems in Behçet's disease, highlighting recent contributions. RECENT FINDINGS Vasculo-Behçet patients are at risk for multiple vessel-related complications including thromboses, stenoses, occlusions, and aneurysms. The primary reason for clot seems to be an inflammatory process in the vessel wall. Less invasive endovascular procedures are increasingly used to treat aneurysms in Behçet patients. SUMMARY Because of earlier recognition, aggressive medical treatment, and novel surgical procedures, the morbidity and mortality of large vessel vasculitis in Behçet's disease are improving.
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Hearing loss in patients with Behçet's disease: an audiological and transient evoked otoacoustic emission study. The Journal of Laryngology & Otology 2009; 124:10-5. [DOI: 10.1017/s0022215109991083] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
AbstractObjective:To investigate hearing loss in patients with Behçet's disease.Materials and methods:Twenty-four consecutive cases of Behçet's disease and 24 sex- and age-matched controls were included in this study. Pure tone and high frequency audiometric tests were performed and pure tone average hearing thresholds calculated for both groups. Transient evoked otoacoustic emission testing was also performed.Results:Pure tone audiometry showed a sensorineural hearing loss in 15 of the Behçet's disease ears. Hearing thresholds were significantly higher in the study group than in the control group, on both pure tone frequency (except 0.5 kHz) and high frequency audiometry. Significant reductions in transient evoked otoacoustic emission amplitude were found at 1.4 and 2 kHz in the Behçet's disease patients. There were no significant differences in reproducibility, stimulus intensity or stability, comparing the Behçet's disease patients and controls.Conclusion:Significantly lower mid-frequency amplitudes were found in Behçet's patients on transient evoked otoacoustic emission testing.
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Rudy C. It's not so sweet. J Pediatr Health Care 2008; 22:387-9. [PMID: 18971086 DOI: 10.1016/j.pedhc.2008.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2008] [Accepted: 07/30/2008] [Indexed: 10/21/2022]
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