Successful treatment of refractory neuro-Behçet’s disease with infliximab: a case report to show its efficacy by magnetic resonance imaging, transcranial magnetic stimulation and cytokine profile

• Published in: Annals of the rheumatic diseases Vol. 66; no. 1; pp. 136 - 137
• Main Authors: Fujikawa, K, Aratake, K, Kawakami, A, Aramaki, T, Iwanaga, N, Izumi, Y, Arima, K, Kamachi, M, Tamai, M, Huang, M, Nakamura, H, Nishiura, Y, Origuchi, T, Ida, H, Eguchi, K
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd and European League Against Rheumatism 01.01.2007; BMJ; BMJ Publishing Group LTD; BMJ Group
• Subjects: Adult; Antibodies, Monoclonal - therapeutic use; Antirheumatic Agents - therapeutic use; Behcet Syndrome - drug therapy; Behcet Syndrome - immunology; Behcet Syndrome - physiopathology; Biological and medical sciences; Blood-brain barrier; Cytokines; Cytokines - analysis; Cytokines - blood; Cytokines - cerebrospinal fluid; Female; Gangrene; Humans; Immunomodulators; Infliximab; Letters; Magnetic Resonance Imaging; Medical sciences; Nervous system; NMR; Nuclear magnetic resonance; Pharmacology. Drug treatments; Proteins; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Transcranial Magnetic Stimulation; Treatment Outcome; Tumor Necrosis Factor-alpha - antagonists & inhibitors; Tumor necrosis factor-TNF; Skin disease; Transcranial magnetic stimulation; Stomatology; Cytokine; Cardiovascular disease; Monoclonal antibody; Nuclear magnetic resonance imaging; Behçet syndrome; Genital diseases; Vascular disease; Case study; Immunomodulator; Refractory; Eye disease; Vasculitis; Treatment; Infliximab; Anticytokine; Systemic disease; Medical imagery; Immunosuppressive agent; Tumor necrosis factor α
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/ard.2006.056804

Previous studies indicate that MEPs evoked through transcranial magnetic stimulation are valuable in monitoring the disease activity or therapeutic response of neuro-Behcet's disease. 4 The appearance of an MEP wave may be indicative of the regeneration process after central nervous system damage, and the present case suggests that transcranial magnetic stimulation can be used as an alternative qualification method to monitor motor tract dysfunction. Neither long-term studies nor clinical trials with large numbers of patients have been carried out on the use of infliximab to treat neuro-Behcet's disease 6, 7 ; however, this case, the first report of an Asian patient, strongly suggests that infliximab brings about an immediate and dramatic improvement in refractory neuro-Behcet's disease, indicating its application in cases of life-threatening neurological manifestations of Behcet's disease.