title: Behçet disease presenting with neurological complications immediately after conversion from conventional cyclosporin A to microemulsion formulation.
abstract: A 53-year-old man with Behçet disease was treated with conventional cyclosporin A (CyA), because of refractory bilateral uveitis. Immediately following the conversion from conventional CyA to a microemulsion formulation, he presented with neurological complications. The neurological findings, pleocytosis of the cerebrospinal fluid (CSF) and brainstem lesions revealed by brain magnetic resonance imaging (MRI) suggested neuro-Behçet disease. After discontinuing CyA and introducing oral prednisolone, the neurological symptoms, pleocytosis of CSF and brainstem lesions on MRI improved. Although the microemulsion formulation, which can maintain a stable level of blood CyA, is a useful agent for the control of ocular lesions in Behçet disease, the resulting abrupt increase in blood CyA level may have induced neuro-Behçet disease.
authors.affiliation: Department of Neurology, Kinki University School of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, Osaka 589-8511.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Mitsui
authors.forename: Manami
authors.initials: M
authors.lastname: Mitsui
authors.forename: Rika
authors.initials: R
authors.lastname: Urakami
authors.forename: Mikihiro
authors.initials: M
authors.lastname: Kihara
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Takahashi
authors.forename: Susumu
authors.initials: S
authors.lastname: Kusunoki
mesh_terms: D000284:Administration, Oral; D001528:Behcet Syndrome / Q000188:drug therapy*; D001927:Brain Diseases / Q000139:chemically induced* / Q000175:diagnosis; D001933:Brain Stem / Q000187:drug effects / Q000473:pathology*; D016572:Cyclosporine / Q000008:administration & dosage*; D003937:Diagnosis, Differential; D004655:Emulsions / Q000008:administration & dosage / Q000009:adverse effects*; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011239:Prednisolone / Q000008:administration & dosage; D012074:Remission Induction
chemical_list: D004655:Emulsions; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D016572:Cyclosporine; D011239:Prednisolone