Neuro-Behçet's disease presenting with tumour-like lesions and responding to rituximab.
We describe a patient with neuro-Behçets disease (NBD) that presented with symptoms of raised intracranial pressure including papilloedema. MRI revealed tumour-like lesions which, on biopsy, confirmed an active vasculitis. Treatment was commenced with prednisone and cyclophosphamide which proved unsuccessful with enlargement of the cerebral mass lesions. Infliximab and mycophenolate were trialled also without benefit. The patient required ventriculoperitoneal shunts to relieve the symptoms of hydrocephalus. Rituximab was then commenced with significant symptomatic and imaging improvement. The case is unique, in our experience, in the need for shunting to relieve the symptoms of hydrocephalus related to vasculitis.
Waikato DHB, Hamilton 3204, New Zealand.
J
J
Jade
Sydney Adventist Hospital Clinic, Wahroonga, NSW 2076, Australia.
K
K
Chung
Waikato DHB, Hamilton 3204, New Zealand.
M
M
Arendse
Waikato DHB, Hamilton 3204, New Zealand.
Z
Z
Hussain
Waikato DHB, Hamilton 3204, New Zealand; Waikato Clinical School, Waikato Hospital, University of Auckland, Pembroke Street, Private Bag 3200, Hamilton 3240, New Zealand. Electronic address: douglas.white@waikatodhb.health.nz.
D
D
White
D000328:Adult; D001528:Behcet Syndrome / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D001921:Brain / Q000000981:diagnostic imaging*; D003520:Cyclophosphamide / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D000069285:Infliximab / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging / Q000379:methods; D009173:Mycophenolic Acid / Q000627:therapeutic use; D010211:Papilledema / Q000188:drug therapy / Q000209:etiology*; D011241:Prednisone / Q000627:therapeutic use; D000069283:Rituximab / Q000627:therapeutic use*; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D000069283:Rituximab; D003520:Cyclophosphamide; D000069285:Infliximab; D009173:Mycophenolic Acid; D011241:Prednisone
Hydrocephalus; MRI; Neuro-Behçet’s; Rituximab; Vasculitis