title: A case of Adamantiades-Behçet disease with ischemic optic neuritis (posterior optic neuropathy).
abstract: Adamantiades-Behçet disease (ABD) may present with cutaneous and ophthalmologic findings. A 29-year old woman complained of fever and general fatigue, along with erythema nodosum and vesiculo-pustular lesions on the legs, acneiform lesions, genital ulcerations and painful oral ulcers. She also complained of reduced visual acuity, visual disturbance and blurred vision in the left eye. Her left visual acuity was 6/20. Light reflex in the left eye was reduced. The relative afferent pupillary defect (RAPD) was positive in the left eye where a central scotoma was present. The vitreous was clear; the optic disc, macula, retina and iris were all normal. Uveitis was not observed. The patient was diagnosed with ischemic optic neuritis (posterior optic neuropathy) with ABD. Histopathological findings taken from a blister on the leg showed subepidermal bulla, dense dermal neutrophil infiltration, and extravasation of erythrocytes, suggesting leukocytoclastic vasculitis. She was treated orally with high-dose corticosteroids (methylprednisolone 500 mg/d) for three days. Her general condition and ophthalmic symptoms resolved completely. Optic neuropathy with ABD is very rare; we know of two previous cases [1, 2] of ABD with ischemic posterior optic neuritis.
authors.affiliation: Department of Dermatology, Mie University Graduate School of Medicine, Mie, Japan.
authors.forename: Satoko
authors.initials: S
authors.lastname: Shima
authors.forename: Keisuke
authors.initials: K
authors.lastname: Nishimura
authors.forename: Kei-ichi
authors.initials: K
authors.lastname: Yamanaka
authors.forename: Arata
authors.initials: A
authors.lastname: Hakamada
authors.forename: Ken-ichi
authors.initials: K
authors.lastname: Isoda
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kurokawa
authors.forename: Koji
authors.initials: K
authors.lastname: Toyoda
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Mizutani
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D001528:Behcet Syndrome / Q000175:diagnosis* / Q000188:drug therapy*; D004893:Erythema Nodosum / Q000175:diagnosis* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008775:Methylprednisolone / Q000008:administration & dosage*; D009902:Optic Neuritis / Q000175:diagnosis* / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone