Refractory Ocular Behçet’s Disease: Outcome of Low Dose Infliximab

Nira Ferdous, Nazrul Islam, Farah Habibur Rahman, Zahedur Rahman Pannu, Fahid Bin Nazrul, Ashik Uz Zaman, Johannes J. Rasker

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Abstract

A 40-year-old woman had been suffering of many symptoms of Behçet’s disease (BD) since her childhood without being diagnosed. She had recurrent mouth ulcers and from the age of 21 vulva ulcers followed by loss of vision due to central retinitis and later also ankle arthritis. At the age of 31, uveitis due to BD was diagnosed. The fact that BD is often not recognized in Bangladesh explains the marked delay in her diagnosis. The initial central retinitis responded well to oral glucocorticoids, azathioprine and cyclosporine, but in the course of time she became refractory to these agents. Considering her financial constraints, low dose Infliximab (3mg/kg) was used resulting in a remarkable but temporal improvement, she came in remission by using 5mg/kg regimen with increased interval time.
We summarize the treatment options for ocular involvement in BD patients
Conclusions: In countries like Bangladesh diagnosis of Behçet’s disease can be delayed. Early cooperation of dermatologists and eye surgeons with rheumatologists is necessary. Most cases of resistant ocular BD can nowadays be successfully treated with anti TNF-agents. Promising results are published with other biologics for refractory and multi-resistant cases.
Original languageEnglish
Pages (from-to)77-85
JournalRheumatology Research
Volume4
Issue number2
DOIs
Publication statusPublished - Apr 2019

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Eye Diseases
Retinitis
Bangladesh
Oral Ulcer
Vulva
Uveitis
Azathioprine
Biological Products
Ankle
Cyclosporine
Glucocorticoids
Ulcer
Arthritis
Infliximab

Cite this

Ferdous, N., Islam, N., Rahman, F. H., Pannu, Z. R., Nazrul, F. B., Zaman, A. U., & Rasker, J. J. (2019). Refractory Ocular Behçet’s Disease: Outcome of Low Dose Infliximab. Rheumatology Research, 4(2), 77-85. https://doi.org/10.22631/RR.2019.69997.1070
Ferdous, Nira ; Islam, Nazrul ; Rahman, Farah Habibur ; Pannu, Zahedur Rahman ; Nazrul, Fahid Bin ; Zaman, Ashik Uz ; Rasker, Johannes J. / Refractory Ocular Behçet’s Disease : Outcome of Low Dose Infliximab. In: Rheumatology Research. 2019 ; Vol. 4, No. 2. pp. 77-85.
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abstract = "A 40-year-old woman had been suffering of many symptoms of Beh{\cc}et’s disease (BD) since her childhood without being diagnosed. She had recurrent mouth ulcers and from the age of 21 vulva ulcers followed by loss of vision due to central retinitis and later also ankle arthritis. At the age of 31, uveitis due to BD was diagnosed. The fact that BD is often not recognized in Bangladesh explains the marked delay in her diagnosis. The initial central retinitis responded well to oral glucocorticoids, azathioprine and cyclosporine, but in the course of time she became refractory to these agents. Considering her financial constraints, low dose Infliximab (3mg/kg) was used resulting in a remarkable but temporal improvement, she came in remission by using 5mg/kg regimen with increased interval time.We summarize the treatment options for ocular involvement in BD patientsConclusions: In countries like Bangladesh diagnosis of Beh{\cc}et’s disease can be delayed. Early cooperation of dermatologists and eye surgeons with rheumatologists is necessary. Most cases of resistant ocular BD can nowadays be successfully treated with anti TNF-agents. Promising results are published with other biologics for refractory and multi-resistant cases.",
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Ferdous, N, Islam, N, Rahman, FH, Pannu, ZR, Nazrul, FB, Zaman, AU & Rasker, JJ 2019, 'Refractory Ocular Behçet’s Disease: Outcome of Low Dose Infliximab', Rheumatology Research, vol. 4, no. 2, pp. 77-85. https://doi.org/10.22631/RR.2019.69997.1070

Refractory Ocular Behçet’s Disease : Outcome of Low Dose Infliximab. / Ferdous, Nira; Islam, Nazrul; Rahman, Farah Habibur; Pannu, Zahedur Rahman; Nazrul, Fahid Bin; Zaman, Ashik Uz; Rasker, Johannes J.

In: Rheumatology Research, Vol. 4, No. 2, 04.2019, p. 77-85.

Research output: Contribution to journalArticleAcademicpeer-review

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T1 - Refractory Ocular Behçet’s Disease

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AU - Ferdous, Nira

AU - Islam, Nazrul

AU - Rahman, Farah Habibur

AU - Pannu, Zahedur Rahman

AU - Nazrul, Fahid Bin

AU - Zaman, Ashik Uz

AU - Rasker, Johannes J.

PY - 2019/4

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N2 - A 40-year-old woman had been suffering of many symptoms of Behçet’s disease (BD) since her childhood without being diagnosed. She had recurrent mouth ulcers and from the age of 21 vulva ulcers followed by loss of vision due to central retinitis and later also ankle arthritis. At the age of 31, uveitis due to BD was diagnosed. The fact that BD is often not recognized in Bangladesh explains the marked delay in her diagnosis. The initial central retinitis responded well to oral glucocorticoids, azathioprine and cyclosporine, but in the course of time she became refractory to these agents. Considering her financial constraints, low dose Infliximab (3mg/kg) was used resulting in a remarkable but temporal improvement, she came in remission by using 5mg/kg regimen with increased interval time.We summarize the treatment options for ocular involvement in BD patientsConclusions: In countries like Bangladesh diagnosis of Behçet’s disease can be delayed. Early cooperation of dermatologists and eye surgeons with rheumatologists is necessary. Most cases of resistant ocular BD can nowadays be successfully treated with anti TNF-agents. Promising results are published with other biologics for refractory and multi-resistant cases.

AB - A 40-year-old woman had been suffering of many symptoms of Behçet’s disease (BD) since her childhood without being diagnosed. She had recurrent mouth ulcers and from the age of 21 vulva ulcers followed by loss of vision due to central retinitis and later also ankle arthritis. At the age of 31, uveitis due to BD was diagnosed. The fact that BD is often not recognized in Bangladesh explains the marked delay in her diagnosis. The initial central retinitis responded well to oral glucocorticoids, azathioprine and cyclosporine, but in the course of time she became refractory to these agents. Considering her financial constraints, low dose Infliximab (3mg/kg) was used resulting in a remarkable but temporal improvement, she came in remission by using 5mg/kg regimen with increased interval time.We summarize the treatment options for ocular involvement in BD patientsConclusions: In countries like Bangladesh diagnosis of Behçet’s disease can be delayed. Early cooperation of dermatologists and eye surgeons with rheumatologists is necessary. Most cases of resistant ocular BD can nowadays be successfully treated with anti TNF-agents. Promising results are published with other biologics for refractory and multi-resistant cases.

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Ferdous N, Islam N, Rahman FH, Pannu ZR, Nazrul FB, Zaman AU et al. Refractory Ocular Behçet’s Disease: Outcome of Low Dose Infliximab. Rheumatology Research. 2019 Apr;4(2):77-85. https://doi.org/10.22631/RR.2019.69997.1070