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Neuro-behçet disease cases with parenchymal and non-parenchymal involvement

Yıl 2019, Cilt: 11 Sayı: 3, 361 - 365, 01.09.2019
https://doi.org/10.21601/ortadogutipdergisi.483568

Öz

Neuro-Behçet’s Disease (NBD) is classified as parenchymal and non-parenchymal involvement. The diagnosis is made by the diagnosis of aphthous lesions, as well as by eye, skin findings, positive pathergy test and vascular lesions. In this article, we aimed to present three cases who presented to our clinic with different neurological complaints and were diagnosed with NBH as a result of clinical evaluations. Our first patient was diagnosed with NBH because of recurrent oral aphthae, genital scar, pathergy test and HLA B51 positivity, magnetic resonance (MR) involvement, and previous Behçet’s disease (BD). In our second case, non-parenchymal involvement was present and widespread cerebral venous thrombosis was detected. The development of gastrointestinal system bleeding with anticoagulant stimulation was associated with GIS involvement and was stimulatory in terms of possible complications of GI. In our last case, there were more than 3 oral aphthae per year, intermittent arthralgia complaints and parenchymal central nervous system involvement and HLA B51 was positive. We wanted to emphasize the need for detailed history and examination of BD in patients with headache, consciousness changes or acute neurological deficits and emphasize the importance of this disease which is common in our country.

Kaynakça

  • Yazici H, Fresko I, Yurdakul S. Behçet’s syndrome: disease manifestations, management and advances in treatment. Nat Clin Pract Rheumatol 2007;3:148–155.
  • Yurdakul S, Hamuryudan V, Yazici H. Behçet syndrome. Curr Opin Rheumatol 2004;16:38.
  • Al-Araji A, Kidd DP. Neuro-Behçet’s disease: epidemiology, clinical characteristics and management. Lancet Neurol 2009;8:192–204.
  • Kidd DP. Neurological complications of Behçet’s syndrome. J Neurol. 2017 Oct;264(10):2178-2183.
  • Davatchi F. Diagnosis/Classification Criteria for Behcet’s Disease. Patholog Res Int 2012;2012:607921.
  • Noel N, Drier A, Wechsler B, ve ark. Neurological manifestations of Behcet’s disease. Rev Med Interne 2014;35(2):112–120.
  • Tunç R, Uluhan A, Melikoğlu M, ve ark. A reassessment of the International Study Group criteria for the diagnosis (classification) of Behçet’s syndrome. Clin Exp Rheumatol 2001;19:S45.
  • Verity DH, Marr JE, Ohno S, Wallace GR, Stanford MR. Behçet’s disease, the Silk Road and HLA-B51: historical and geographical perspectives. Tissue Antigens 1999;54:213–220.
  • Zouboulis CC, Vaiopoulos G, Marcomichelakis N, ve ark. Onset signs, clinical course, prognosis, treatment and outcome of adult patients with Adamantiades-Behçet’s disease in Greece. Clin Exp Rheumatol 2003;21:S19.
  • Akman-Demir G, Serdaroglu P, Tasçi B. Clinical patterns of neurological involvement in Behçet’s disease: evaluation of 200 patients. The Neuro-Behc¸et Study Group. Brain 1999;122(Pt 11):2171–2182.

Parankimal ve non-parankimal tutulum gösteren nöro-behçet hastalığı olguları

Yıl 2019, Cilt: 11 Sayı: 3, 361 - 365, 01.09.2019
https://doi.org/10.21601/ortadogutipdergisi.483568

Öz

Nöro-Behçet Hastalığı (NBH) parankimal ve non-parankimal tutulum olarak sınıflandırılmıştır. Tanı aftöz lezyonların yanında göz, cilt bulguları, paterji testi pozitifliği ve vasküler lezyonların tanınması ile konmaktadır. Bu yazımızda kliniğimize farklı nörolojik yakınmalarla başvuran ve klinik değerlendirmeler sonucunda NBH tanısı alan 3 olgu sunmayı amaçladık. Birinci olgumuzda tekrarlayan oral aftlar, genital skar, paterji testi ve HLA B51 pozitifliği, magnetic rezonans (MR) tutulum özellikleri ve öncesinde Behçet hastalığı (BH) tanısı almış olması nedeniyle NBH tanısı konuldu. İkinci olgumuzda non-parankimal tutulum mevcuttu ve yaygın serebral venöz tromboz saptandı. Antikoagülan kullanımı ile gastrointestinal system (GİS) kanama gelişmesi BH’nın GİS tutulumu ve olası komplikasyonlar açısından uyarıcıydı. Son olgumuzda yılda 3 ten fazla oral aft öyküsü, aralıklı artralji yakınmaları ve parankimal merkezi sinir sistemi tutulumu mevcuttu ve HLA B51 pozitifti. Baş ağrısı, bilinç değişiklikleri veya akut nörolojik defisitler gibi farklı klinik tablolarla başvurabilen olgularda BH açısından gerekli öykü ve muayenenin detaylı yapılması gerektiğini hatırlatmak ve ülkemizde sık görülen bu hastalığın önemine vurgu yapmak istedik.

Kaynakça

  • Yazici H, Fresko I, Yurdakul S. Behçet’s syndrome: disease manifestations, management and advances in treatment. Nat Clin Pract Rheumatol 2007;3:148–155.
  • Yurdakul S, Hamuryudan V, Yazici H. Behçet syndrome. Curr Opin Rheumatol 2004;16:38.
  • Al-Araji A, Kidd DP. Neuro-Behçet’s disease: epidemiology, clinical characteristics and management. Lancet Neurol 2009;8:192–204.
  • Kidd DP. Neurological complications of Behçet’s syndrome. J Neurol. 2017 Oct;264(10):2178-2183.
  • Davatchi F. Diagnosis/Classification Criteria for Behcet’s Disease. Patholog Res Int 2012;2012:607921.
  • Noel N, Drier A, Wechsler B, ve ark. Neurological manifestations of Behcet’s disease. Rev Med Interne 2014;35(2):112–120.
  • Tunç R, Uluhan A, Melikoğlu M, ve ark. A reassessment of the International Study Group criteria for the diagnosis (classification) of Behçet’s syndrome. Clin Exp Rheumatol 2001;19:S45.
  • Verity DH, Marr JE, Ohno S, Wallace GR, Stanford MR. Behçet’s disease, the Silk Road and HLA-B51: historical and geographical perspectives. Tissue Antigens 1999;54:213–220.
  • Zouboulis CC, Vaiopoulos G, Marcomichelakis N, ve ark. Onset signs, clinical course, prognosis, treatment and outcome of adult patients with Adamantiades-Behçet’s disease in Greece. Clin Exp Rheumatol 2003;21:S19.
  • Akman-Demir G, Serdaroglu P, Tasçi B. Clinical patterns of neurological involvement in Behçet’s disease: evaluation of 200 patients. The Neuro-Behc¸et Study Group. Brain 1999;122(Pt 11):2171–2182.
Toplam 10 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Sağlık Kurumları Yönetimi
Bölüm Vaka sunumu
Yazarlar

Abdulkadir Tunç 0000-0002-9747-5285

Nihat Mustafayev Bu kişi benim 0000-0003-2923-7661

Azize Esra Gürsoy Bu kişi benim 0000-0002-8103-0927

Vildan Güzel 0000-0003-4954-6402

Gülsen Babacan Yıldız Bu kişi benim 0000-0003-0922-0969

Elif Gökçal Bu kişi benim 0000-0003-3309-4368

Yayımlanma Tarihi 1 Eylül 2019
Yayımlandığı Sayı Yıl 2019 Cilt: 11 Sayı: 3

Kaynak Göster

Vancouver Tunç A, Mustafayev N, Gürsoy AE, Güzel V, Babacan Yıldız G, Gökçal E. Parankimal ve non-parankimal tutulum gösteren nöro-behçet hastalığı olguları. otd. 2019;11(3):361-5.

e-ISSN: 2548-0251

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