Efficacy of TNF a blockade in cyclophosphamide resistant neuro-Behcet disease
Efficacy of TNF a blockade in cyclophosphamide resistant neuro-Behcet disease
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DOI：
10.1136/jnnp.2004.055434
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发表时间：
2005-12-01
影响因子：
11
通讯作者：
Chizzolini, C
中科院分区：
文献类型：
--
作者：
Ribi, C;Sztajzel, R;Chizzolini, C
白塞氏病是一种慢性复发性炎症性疾病，主要影响年轻人，其特征是复发性双相口疮和全身表现，肿瘤坏死因子（TNF）α阻断最近已成为一种有效的治疗方法。我们报告的情况下，病人提出与粘膜皮肤和眼部的表现谁在他的疾病过程中发展中枢神经系统实质参与。在接受环磷酰胺和皮质类固醇脉冲治疗时，他的CNS受累复发，通过英夫利西单抗有效控制。与硫唑嘌呤、秋水仙碱和皮质类固醇相关的TNF阻断治疗一整年期间，未观察到疾病活动。然而，英夫利西单抗末次给药后7个月，仍在使用免疫抑制剂，CNS病变复发。英夫利西单抗成功地重新引入，并继续没有副作用。在该患者中观察到的事件序列表明TNF阻断剂在抑制神经白塞氏病中是有效的，并且一旦引入就应维持较长的时间。
Behcet disease is a chronic relapsing inflammatory condition, predominantly affecting young adults, characterised by recurrent bipolar aphtae and systemic manifestations for which tumour necrosis factor (TNF) alpha blockade has recently emerged as an effective treatment. We report the case of a patient presenting with mucocutaneous and ocular manifestations who in the course of his disease developed CNS parenchymal involvement. While being treated with pulsed cyclophosphamide and corticosteroids, he suffered a relapse of his CNS involvement that was efficaciously controlled by infliximab. No disease activity was observed during a full year of TNF blockade, associated with azathioprine, colchicine, and corticosteroids. However, 7 months after the last administration of infliximab and still under immunosuppressant agents, CNS lesions recurred. Infliximab was successfully reintroduced and since continued with no side effects. The sequence of events observed in this patient suggests that TNF blockade is efficacious in suppressing neuro-Behcet disease and once introduced should be maintained for a prolonged period of time.